RHABDOMYOLYSIS

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RHABDOMYOLYSIS

• What you need to know

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• Rhabdomyolysis is a common disorder which
  may result from a large variety of diseases,
  trauma, or toxic insults to skeletal muscle. It
  may be defined as a clinical and biochemical
  syndrome resulting from an injury which damages
  the integrity of the sarcolemma of skeletal
  muscle, leading to the release of potentially
  toxic muscle cell components into the
  circulationThis may result in potential
  life-threatening complications including
  myoglobinuric acute renal failure, hyperkalaemia
  and cardiac arrest, disseminated intravascular
  coagulation, and more locally, compartment
  syndrome.
• -http//members.tripod.com/baggas/rhabdo.html

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• We can dispose with much medical detail with a
  quick and easy description of rhabdomyolysis as a
  potentially lethal systemic meltdown initiated by
  the kidneys in response to the presence of shed
  muscle-fiber debris and exhaust in the
  bloodstream.
• Crossfit Journal 2005, Issue 38

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What Happens

• Muscle cells are damaged
• Releases muscle fiber content into the
  bloodstream
• Potassium and myoglobin is released into
  bloodstream, calcium and sodium build up in the
  muscle cells
• Myoglobin breaks down into ferrihemate in the
  kidneys
• Kidney damage occurs, can cause acute renal
  failure (and death)
• Potassium can cause alterations in heart function
• High enough levels can cause arrythmia and heart
  failure (and death)

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History

• Five cases recorded with this type of workout
• All athletes were previously involved in
  low-intensity, low power output workouts
• All athletes were fit (ex SWAT member, Special
  Forces member)
• All athletes made a complete recovery
• All continue to do this kind of workout (without
  another occurrence of rhabdo).

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Drug Reactions

• Toxic-mediated rhabdomyolysis may result from
  prescription and nonprescription medications,
  including the following
• Mevacore (lovastatin)
• Antihistamines
• Salicylates
• Caffeine
• Fibric acid derivatives (eg, bezafibrate,
  clofibrate, fenofibrate, gemfibrozil)
• Neuroleptics
• Anesthetic and paralytic agents (the malignant
  hyperthermia syndrome)
• Amphotericin B
• Quinine
• Corticosteroids
• Atorvastatin
• Fluvastatin
• Lovastatin
• Pitavastatin (marketed in Japan, South Korea,
  India)
• Pravastatin
• Rosuvastatin
• Simvastatin
• Cerivastatin (recalled from US market)

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Substance Abuse

• Toxin-mediated rhabdomyolysis may result from
  substance abuse, including abuse of the
  following
• Ethanol
• Methanol
• Ethylene glycol
• Isopropanol
• Heroin
• Methadone
• Barbiturates
• Cocaine
• Amphetamine
• Phencyclidine
• 3,4-methylenedioxymethamphetamine (MDMA, ecstasy)
  
• Lysergic acid diethylamide (LSD)

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Symptoms

• Brown Urine
• NOT yellow, go IMMEDIATELY to the hospital!
• Muscle weakness
• Extreme soreness that lasts more than two/three
  days

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Prevention

• Hydrate with water beforehand
• At least four hours prior start drinking water
• Stop all caffeine intake
• Hydrate during and after the exercise
• Monitor body signs throughout workout
• Dont work out or compete if you have a cold/flu
• Rhabdo is EASY to prevent

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Bibliography

• Crossfit Journal 2005, Issue 38
• http//www.crossfit.com/cf-journal/rhabdo.pdf
• Rhabdomyolysis
• http//members.tripod.com/baggas/rhabdo.html
• eMedicine Rhabdomyolysis
• http//www.emedicine.com/emerg/topic508.htm