Rhabdomyolysis

Differential Diagnosis

• Acquired
  • Trauma (crush syndrome)
  • Exertion
  • Ischemia
  • Medications, including statins, fibrates, antipsychotics, and others
  • Illicit drug use, including cocaine, heroin, and LSD
  • Alcohol use, either acute or chronic
  • Infections, including bacteria (such as Legionella, but also Escherichia coli, Salmonella, Streptococcus pyogenes, Staphylococcus aureus, tularemia, Clostridium, and other causes of sepsis), viruses (including influenza, but also others such as CMV, HSV, EBV, HIV, and coxsackievirus), and parasites
  • Hyperthermia, hypothermia
  • Neuroleptic malignant syndrome
  • Hyperthyroidism, hypothyroidism, diabetes
  • Spider bite, wasp sting, snake venom
• Inherited
  • Glycogen storage disease, fatty acid disorders, mitochondrial disorders
  • Dystrophinopathy, dysferlinopathy
  • RYR1 gene mutation, SCN4A gene mutation
  • Lipi-1 gene mutation
  • Sickle cell disease
  • Benign exertional rhabdomyolysis

Further Reading

• Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice. BMC Crit Care. 2016;135.