Rabdomioliz

Description:

Rabdomioliz — the syndrome representing extreme degree of a myopathy and which is characterized by destruction of cells of muscular tissue, sharp increase in level of a creatine kinase and myoglobin, a myoglobinuria, development of an acute renal failure.

Rabdomioliz's symptoms:

The clinical picture depends on severity of a rabdomioliz. At easy forms pathology from muscles can be not revealed, at the same time diagnose a state on changes in blood. In more hard cases there are muscle pain, weakness and puffiness of muscles. If puffiness increases quickly (for example, at a syndrome of a long prelum), the movement of liquid from blood in the affected muscle can lead to the low blood pressure and shock. Hit of decomposition products of muscles brings into a blood stream to disturbance of electrolytic structure that makes sick, vomiting, confusion, a coma or disturbance of a heart rhythm. Urine can be dark (tea color) that is caused by existence of a myoglobin in it. At injury of kidneys there is no formation of urine, as a rule, in 12-24 hours after injury of muscles.

Symptoms and symptoms of a renal failure are similar to that at OPN of other etiology.

Rabdomioliz's reasons:

  1. Syndrome of a long prelum
  2. Inherited disorders of metabolism
  3. Electrolytic disturbances (hypopotassemia, hypophosphatemia)
  4. Myopathies
  5. Polymiositis, dermatomyositis
  6. Malignant hyperthermia
  7. A malignant syndrome at reception of some HP (anesthetics, fenotiazina, MAO inhibitors)
  8. Muscular tension (physical, secondary at spasticity or heatstroke)
  9. Injuries
  10. Ischemia of muscles at occlusion of arteries or cardiovascular insufficiency
  11. Burns
  12. Repeated injuries of muscles, long pressure upon muscles
  13. Epileptic status
  14. Infectious diseases
        1. Viruses (flu A, Epstein-Barre, chicken pox)
        2. Bacteria
  15. Toxic injuries of muscles
        1. Alcohol
        2. Poison of snakes and some scolopendras (at stings).
        3. Carbon monoxide (carbon monoxide)
        4. Cocaine, heroin, amphetamine
  16. Overdose of HP
        1. Theophylline
        2. Isoniazid
  17. Malignant new growths (acute necrotic myopathy of tumors)
  18. diabetes mellitus.

Rabdomioliz's treatment:

  1. Obligatory hospitalization
  2. At the necrosis of skeletal muscles caused by infringement surgical intervention sometimes is shown
  3. At a heavy renal failure dialysis is necessary
  4. Treatment of a hypocalcemia
Physical activity — an exercise stress can lead to an acute necrosis of skeletal muscles, especially at persons with metabolic myopathies. A diet — at OPN restriction in food of proteins (for decrease in level of an urea nitrogen in blood) and kaliysoderzhashchy products is necessary.
Medicinal therapy. At an acute necrosis of skeletal muscles for the prevention of development of a renal failure — increase in release of urine up to 150 ml/h (3 ml/kg/h)
  1. Mannitolum of 12,5-25 in/in
  2. Infusion of Natrii hydrocarbonas (to рН urine 7,0-7,5) for reduction of mioglobinovy damage of tubules.