Myoglobinuria

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Myoglobinuria
Classification and external resources
RhabdoUrine.JPG
Urine from a person with rhabdomyolysis showing the characteristic brown discoloration as a result of myoglobinuria
ICD-10 R82.1
ICD-9 791.3
DiseasesDB 23059
eMedicine ped/1535
MeSH D009212
Model of helical domains in myoglobin.

Myoglobinuria is the presence of myoglobin in the urine, usually associated with rhabdomyolysis or muscle destruction. Myoglobin is present in muscle cells as a reserve of oxygen.

Causes[edit]

Trauma, vascular problems, venoms, malignant hyperthermia, certain drugs and other situations can destroy or damage the muscle, releasing myoglobin to the circulation and thus to the kidneys.

Under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of renal problems, it can occlude the renal filtration system leading to acute tubular necrosis and acute renal insufficiency.

Other causes of myoglobinuria include:

Diagnosis[edit]

After centrifuging, the urine of myoglobinuria is clear, where the serum of hemoglobinuria after centrifuge is pink to red.

Treatment[edit]

Hospitalization and IV hydration should be the first step in any patient suspected of having myoglobinuria or rhabdomyolysis. The goal is to induce a brisk diuresis to prevent myoglobin precipitation and deposition, which can cause acute kidney injury. Mannitol can be added to assist with diuresis. Adding sodium bicarbonate to the IV fluids will cause alkalinzation of the urine, believed to reduce the breakdown of myoglobin into its nephrotoxic metabolites, thus preventing renal damage. Often, IV normal saline is all that is needed to induce diuresis and alkalinize the urine.

External links[edit]

  • Overview on the Neuromuscular disease center website.

References[edit]

  1. ^ Toscano A, Musumeci O (October 2007). "Tarui disease and distal glycogenoses: clinical and genetic update". Acta Myol 26 (2): 105–7. PMC 2949577. PMID 18421897.