- Rhabdomyolysis is a clinical syndrome that comprises destruction of skeletal muscle with outflow of intracellular muscle content into the bloodstream.
- The systemic complications associated with rhabdomyolysis result from the leakage of muscle intracellular components into the bloodstream.
- Elevated Creatine kinase (CK) hallmark of rhabdomyolysis.
- Defined based on CK values five times above the upper limit of normal.
- Half-life of CK is 1.5 days; elevated<12hrs, peaks in 3 days, & normalizes in 5 days.
- Myoglobin half-life of 2-3 hrs & rapidly excreted by kidneys.
- Rapid & unpredictable metabolism makes myoglobin less useful marker of muscle injury.
- Antibiotics associated with rhabdomyolysis: Daptomycin, macrolides, trimethoprim-sulfamethoxazole, linezolid, fluoroquinolones, and cefdinir.
- Rhabdomyolysis is associated with hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.
Management includes appropriate hydration to improve end-organ perfusion, close monitoring of urine output, correction of electrolyte abnormalities, identification of complications like compartment syndrome, and disseminated intravascular coagulation.
