01 January 2008
Myoglobinuria caused by exertional rhabdomyolysis misdiagnosed as psychiatric illness
Miroslaw BanasikABCDEF, Jakub KuzniarABCDEF, Mariusz KusztalCD, Tomasz PorazkoBD, Waclaw WeydeAD, Marian KlingerADMed Sci Monit 2008; 14(1): CS1-4 :: ID: 666312
Abstract
Background
Rhabdomyolysis is severe and acute skeletal muscle damage resulting in sarcolemma disruption. During injury, intracellular muscle contents are released into the plasma. The consequences may cause hypovolemia, electrolyte abnormalities, compartment syndrome, or even acute renal failure and dialysis.
Material and Method
We present the history of a patient in whom exertional rhabdomyolysis was misdiagnosed. A 20-year-old male police recruit was admitted to a psychiatric hospital because of complaints about black urine and severe thigh pain. Serum creatinine kinase (CK) was significantly elevated at 87,335 U/l. Urinalysis showed brown color and cloudiness. Serum myoglobin was also significantly increased. Aspartate aminotransferase was elevated as was alanine aminotransferase. Immediate intravascular fluid hydration and hospital rest under renal, metabolic, and hematological monitoring was performed.
Results
Conclusions
Gymnastic teachers and people at environmental risk of rhabdomyolysis, such as members of the armed forces, police, and supervisors of physical laborers, need to remember the risks of intensive and repetitive exercise. Symptoms such as dark urine, myalgia, and muscle weakness should immediately arouse suspicion of rhabdomyolysis. Especially dark-colored urine should always be investigated for the occurrence of rhabdomyolysis.
Keywords: Physical Exertion - physiology, Myoglobinuria - psychology, Mental Disorders - diagnosis, Rhabdomyolysis - urine, Diagnostic Errors
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
26 Feb 2024 : Clinical Research
Predictive Value of Combined HbA1c and Neutrophil-to-Lymphocyte Ratio for Diabetic Peripheral Neuropathy in...Med Sci Monit In Press; DOI: 10.12659/MSM.942509
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952