Scalco, RS;
Snoeck, M;
Treves, S;
Quinlivan, R;
Laforet, P;
Jungbluth, H;
Voermans, N;
(2016)
Exertional rhabdomyolysis: Physiological response or manifestation of an underlying myopathy?
BMJ Open Sport & Exercise Medicine
, 2
(1)
, Article e000151. 10.1136/bmjsem-2016-000151.
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Abstract
Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Severe muscle pain, sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria are the key features, although mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown. Repeated episodes of exertional rhabdomyolysis should raise the suspicion of such an underlying disorder, in particular in individuals in whom the severity of the rhabdomyolysis episodes exceeds the expected response to the exercise performed. The present review aims to provide a practical guideline for the acute management and post-episode counselling of patients with exertional rhabdomyolysis, with a particular emphasis on when to suspect an underlying genetic disorder. The pathophysiology and its clinical features are reviewed, emphasizing four main step-wise approaches: 1) the clinical significance of an acute episode, 2) risks of renal impairment, 3) clinical indicators of an underline genetic disorders and 4) when and how to recommence sport activity following an acute episode of rhabdomyolysis. Genetic backgrounds that appear to be associated with both enhanced athletic performance and an increased rhabdomyolysis risk are briefly reviewed.
| Type: | Article |
|---|---|
| Title: | Exertional rhabdomyolysis: Physiological response or manifestation of an underlying myopathy? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjsem-2016-000151 |
| Publisher version: | http://dx.doi.org/10.1136/bmjsem-2016-000151 |
| Language: | English |
| Additional information: | This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Rhabdomyolysis, exertional rhabdomyolysis, exercise, genetic, myopathy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1513288 |
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