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Tytuł:
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Rhabdomyolysis: review of the literature.
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Autorzy:
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Zutt R; Department of Neurology, Academic Medical Center, University of Amsterdam/University Medical Center Groningen, The Netherlands.
van der Kooi AJ; Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands. Electronic address: .
Linthorst GE; Department of Internal Medicine/Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands.
Wanders RJ; Department of Paediatrics and Clinical Chemistry, Academic Medical Center, University of Amsterdam, The Netherlands.
de Visser M; Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands.
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Źródło:
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Neuromuscular disorders : NMD [Neuromuscul Disord] 2014 Aug; Vol. 24 (8), pp. 651-9. Date of Electronic Publication: 2014 May 21.
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Typ publikacji:
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Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Original Publication: Oxford ; New York : Pergamon Press, c1991-
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MeSH Terms:
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Rhabdomyolysis/*diagnosis
Rhabdomyolysis/*therapy
Animals ; Humans ; Rhabdomyolysis/genetics ; Rhabdomyolysis/physiopathology
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Contributed Indexing:
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Keywords: Myoglobinuria; Rhabdomyolysis
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Entry Date(s):
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Date Created: 20140621 Date Completed: 20150302 Latest Revision: 20220409
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Update Code:
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20240104
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DOI:
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10.1016/j.nmd.2014.05.005
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PMID:
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24946698
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Rhabdomyolysis is a serious and potentially life threatening condition. Although consensus criteria for rhabdomyolysis is lacking, a reasonable definition is elevation of serum creatine kinase activity of at least 10 times the upper limit of normal followed by a rapid decrease of the sCK level to (near) normal values. The clinical presentation can vary widely, classical features are myalgia, weakness and pigmenturia. However, this classic triad is seen in less than 10% of patients. Acute renal failure due to acute tubular necrosis as a result of mechanical obstruction by myoglobin is the most common complication, in particular if sCK is >16.000 IU/l, which may be as high as 100,000 IU/l. Mortality rate is approximately 10% and significantly higher in patients with acute renal failure. Timely recognition of rhabdomyolysis is key for treatment. In the acute phase, treatment should be aimed at preserving renal function, resolving compartment syndrome, restoring metabolic derangements, and volume replacement. Most patients experience only one episode of rhabdomyolysis, mostly by substance abuse, medication, trauma or epileptic seizures. In case of recurrent rhabdomyolysis, a history of exercise intolerance or a positive family history for neuromuscular disorders, further investigations are needed to identify the underlying, often genetic, disorder. We propose a diagnostic algorithm for use in clinical practice.
(Copyright © 2014 Elsevier B.V. All rights reserved.)