Rhabdomyolysis

Propose: Rhabdomyolysis is a rare but serious syndrome that can cause severe damage to the body.

Learning Objectives: What is rhabdomyolysis?1,2,5 What causes it?1,5 Signs/Symptoms1,2,5 Effects of rhabdomyolysis1,2,5 Relevance to older adults Management of the condition5 Test to diagnose condition Additional resources for more info References
 * To understand what rhabdomyolysis is and what causes it
 * Recognize the signs and symptoms of rhabdomyolysis
 * Understand how rhabdomyolysis effects older adults
 * Understand management of the condition
 * Syndrome caused by injury to the skeletal muscle
 * Disruption of the skeletal muscle integrity leads to the release of intracellular components (myoglobin, creatine kinase, aldolase, lactate dehydrogenase, electrolytes) into the blood stream
 * It ranges from asymptomatic to life threatening
 * Direct trauma-falls, accidents, crush injury
 * Drugs (statins), toxins
 * Exertion or prolonged bed rest
 * Infections
 * Muscle ischemia
 * Metabolic or genetic disorders
 * Neuroleptic malignant syndrome and Malignant hyperthermia (extreme body temperature)
 * Muscle aches 
 * Dark-colored urine 
 * Weakness 
 * Nauseas/Vomiting
 * Fever, malaise
 * Tachycardia, arrhythmias
 * Acute renal failure
 * Electrolyte imbalances
 * Intravascular coagulation
 * Compartment syndrome
 * Falls may be a large risk factor for rhabdomyolysis in older adults3
 * Older adults with prolonged used of statins, especially at higher doses, could be at an increased risk for developing rhabdomyolysis in comparison to the general public3,4
 * It is possible that older adults are at an increased risk of developing acute kidney injury after developing rhabdomyolysis3
 * IV Fluids
 * Replenish electrolytes
 * Kidney dialysis in severe cases
 * Fasciotomy for compartment syndrome in severe cases
 * Creatine Kinase Levels
 * Serum Calcium, Serum myoglobin, Serum potassium
 * Urinalysis
 * https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024696/
 * https://medlineplus.gov/ency/article/000473.htm
 * https://www.youtube.com/watch?v=Hy0uEPo8-7w
 * http://jasn.asnjournals.org/content/11/8/1553.full
 * https://www.healthline.com/health/rhabdomyolysis
 * 1) Torres P, Helmstetter J, Kaye A. Rhabdomyolysis: pathogenesis, diagnosis, and treatment.  The Ochsner Journal. 2015; 15(1)58-69.
 * 2) Chatzizisis Y, Misirli G, Hatzitolios G, et al. The syndrome of rhabdomyolysis: complications and treatment. European Journal of Internal Medicine. 2008;19(8):568-574.
 * 3) Wongrakpanich S, Kallis C, Prasad P, et al. The study of rhabdomyolysis in the elderly: an epidemiological study and single center experience. Aging and Disease. 2018;9(1):1-7.
 * 4) Iwere R, Hewitt J. Myopathy in older people receiving statin therapy: a systematic review and meta-analysis. Br J Clin Pharmacol. 2015;80(3):363-371.
 * 5) Sauret J, Marinides G, Wang G. Rhabdomyolysis. American Family Physician. 2002;65(5):907-913.