Exercise-Induced Rhabdomyolysis☆,☆☆,★
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INTRODUCTION
Since the original description of the syndrome of muscle pain, weakness, and brown urine by Meyer-Betz in 1910,1 numerous case reports have linked rhabdomyolysis to such strenuous activities as military basic training2, 3 and weight lifting.4 Knochel5 has termed exercise-induced rhabdomyolysis "white collar rhabdomyolysis" because of its high incidence in intelligent, well-educated professionals who can arrange their work schedules to allow for daily running. Although training probably
MATERIALS AND METHODS
This study was designed as a retrospective cohort analysis of all cases of exercise-induced rhabdomyolysis. Medical records were reviewed for a five-year period (January 1988 to January 1993) using a computer search of the ICD-9 code (728.89) for both the primary and secondary discharge diagnoses of rhabdomyolysis. The study inclusion criteria for exercise-induced rhabdomyolysis were an elevated CPK concentration of more than 500 U/L (normal, 150 U/L or less), myoglobinuria, and a history of
RESULTS
The study population consisted of 35 male patients with an average age of 24.4 ± 5.4 years. Nineteen patients were black, 15 were Hispanic, and one was white. All patients were imprisoned at Rykers Correctional Institution at the time of admission.
Past medical history did not disclose previous episodes of rhabdomyolysis in any of the patients. No patient described similar histories of muscle weakness from exercise or family members with any muscle problems. Although nine patients gave a history
DISCUSSION
The clinical significance of rhabdomyolysis lies in its association with myoglobinuric acute renal failure and its subsequent mineral and electrolyte derangements. The 35 cases reported in this study are unique not only for their similarity in presentation but also for their lack of acute renal failure.
The incidence of acute renal failure secondary to rhabdomyolysis from all causes has been investigated. Studies by Ward,13 Gabow et al,14 and Kageyama15 found the incidence of
CONCLUSION
Rhabdomyolysis is a relatively common complication of strenuous exercise, as evidenced by the military recruit data8 and the large number of reports of "white collar rhabdomyolysis" gathered by Knochel.5 Reports of exercise-induced rhabdomyolysis in professional athletes6, 7 support our experience that neither the amount of exercise nor the level of training appears to be a reliable predictor for the development of rhabdomyolysis.
Exercise-induced rhabdomyolysis accounted for 47% of our
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Cited by (0)
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From the Department of Emergency Medicine, State University of New York Health Science Center at Brooklyn/Kings County Hospital Center, Brooklyn, New York.
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Address for reprints: Richard Sinert, DO, Department of Emergency Medicine, State University of New York Health Science Center at Brooklyn/Kings, County Hospital, Box 1228, 450 Clarkson Ave, Brooklyn, New York 11203, 718-245-4795, Fax 718-245-4799
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Reprint no. 47/1/56030