Rhabdomyolysis is a disease where skeletal muscle breaks down, sometimes leading to kidney/renal failure. This fatal disease has been around for centuries, but it wasn't until the 20th century that the disease was seriously studied by researchers and doctors.
Early References
According to some scholars, the disease may have been known as early as biblical times (resources 1 and 2). The Bible contains a reference to what may be rhabdomyolysis in Numbers 11:31--33. The Jews demand food during their travels in the desert. They are given quail, but then a plague broke out. Rhabdomyolysis is also sometimes called "coturnism" (after Coturnix, the main quail genus). Wild quail eat hemlock, and the toxins in that plant can cause people who consume them in great quantities to become ill. (But most modern quail are safe to eat, see Resources for more information.)
Pioneering Work in the 20th Century
In the early part of the 20th century, doctors who examined patients after earthquakes and the 1941 Blitz made advances learning about this condition. The doctors believed that myoglobin might have been a factor, as it was found in the urine of the victims. In 1944, one doctor known as E. Bywaters conducted an experiment that proved that renal failure was caused by myoglobin.
Causes
Rhabdomyolysis can be caused by blunt trauma that compressed the muscles, obstruction of the flow of blood, being struck by lightning or prolonged and excessive physical activity. Other causes of the disease have also been reported, such as food poisoning, drug abuse and some kinds of infections.
Symptoms
Pain, weakness and swelling are often the first symptoms. During a crush injury, muscle tissue cells can release some of their constituent elements (such as myoglobin) into the bloodstream, and this will cause symptoms like nausea, vomiting and disorientation. In some cases, coma or heart problems can also develop. If the kidneys are damaged, dark-colored urine will be produced. Laboratory tests of blood serum levels that show creatine kinase (a substance found in healthy intermembrane space in muscle cells) can also alert doctors to the possibility of the condition. Elevated serum myoglobin levels or myoglobinuria are also red flags.
Treatments
Doctors attempting to treat rhabdomyolysis keep a patient's electrolyte levels monitored, and adjust them when necessary. They also ensure that enough fluids are given to aid kidney function. Intravenous drips of saline are used to stabilize patients. Dialysis must be used in some of the more serious cases.
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