|Classification and external resources|
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:
- McArdle's disease
- Phosphofructokinase deficiency
- Carnitine palmitoyltransferase II deficiency
- malignant hyperthermia
After centrifuging, the urine of myoglobinuria is clear, where the serum of hemoglobinuria after centrifuge is pink to red.
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.
- Overview on the Neuromuscular disease center website.
- 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.
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