Destruction of skeletal muscles. Rhabdomyolysis: causes, symptoms, diagnosis, treatment

Myositis is any disease that causes muscle inflammation. Weakness, swelling and pain are the most common symptoms of myositis. Myositis can be caused by infections, injuries, and autoimmune causes. Myositis can also occur as a side effect from taking certain medicines. Treatment for myositis varies depending on its cause.

Causes of myositis

Myositis is caused by any condition that causes muscle inflammation. The causes of myositis can be divided into several categories:

Inflammatory diseases

This category includes all diseases characterized by an intense inflammatory process, which can also affect muscle tissue, leading to the development of myositis. Most of these conditions are autoimmune in nature. In autoimmune inflammation, the body begins to attack its own tissues. Inflammatory diseases that cause potentially serious myositis include:

• dermatomyositis;
• polymyositis;
• inclusion body myositis.

Other inflammatory diseases, causing milder forms of myositis include:

• systemic lupus erythematosus;
• scleroderma;
• rheumatoid arthritis.

Typically, inflammatory diseases cause the most serious forms of myositis, which require long-term treatment.

Infections

Most often, myositis is caused by various viral infections, less often by bacteria, fungi and other organisms. Viruses or bacteria can infect muscle tissue directly or produce substances that damage muscle fibers. Colds, flu and HIV can cause myositis, as can many other infections.

Medicinal substances

Many different medications can cause temporary muscle damage. Because muscle inflammation is often unidentified, the muscle problem is referred to as myopathy rather than myositis. Drugs that cause myositis or myopathy include:

• statins;
• colchicine;
• Plaquenil (hydroxychloroquine);
• alpha interferon.

Myopathies may appear immediately after starting treatment or occur after several months or years of taking the drug. Sometimes myopathy is caused by an interaction between two different medications. Severe myositis is rarely associated with medications.

Injuries

Vigorous exercise can lead to muscle pain, swelling, and weakness for many hours or days after exercise. The presence of inflammation allows this form of pain to be formally classified as myositis; in fact, in this case the person experiences muscle pain (myalgia). Symptoms of myalgia after exercise or injury almost always go away on their own with rest and recovery.

Acute skeletal muscle necrosis (rhabdomyolysis)

Acute necrosis skeletal muscles- This is an extreme degree of myopathy in which muscle destruction occurs. Muscle pain, weakness and swelling are symptoms of radbomyolysis. In some cases, the urine of such a patient becomes dark brown or red in color.

Symptoms of myositis

The main symptom of myositis is muscle weakness. It may be noticeable, or it may only be detected through tests. Muscle pain (myalgia) may or may not be present. Dermatomyositis, polymyositis and other inflammatory diseases cause weakness that progresses slowly over weeks or months. Weakness affects numerous muscle groups, including the neck, shoulder, hip and back. Muscles on both sides of the body are usually affected.

Weakness caused by myositis can lead to falls and difficulty getting up from a chair. Other symptoms that may accompany inflammatory diseases include:

• rash;
• fatigue;
• thickening of the skin on the hands;
• difficulty swallowing;
• difficulty breathing.

People with myositis caused by a viral infection usually have symptoms consistent with the infection, such as a stuffy nose, fever, cough and sore throat, or nausea and diarrhea. But symptoms of a viral infection may subside several days or weeks before symptoms of myositis appear.

Some patients with myositis experience muscle pain, but many do not.

Most cases of muscle pain are not caused by myositis, but by muscle strains or common illnesses such as colds and flu. This muscle pain is called myalgia.

Diagnosis of myositis

First, your doctor will ask you to describe your symptoms. It is very important to describe the exact location of muscle pain and weakness, as well as the duration of these symptoms. The doctor will also review your medical history and current medications.

Afterwards, the doctor will conduct an examination, paying special attention to the muscles and nerves. Depending on what the doctor finds, he or she may suggest further testing.

Diagnostic methods

Your doctor may suspect myositis based on muscle weakness and other symptoms. The following diagnostic methods are also used to diagnose myositis:

• blood analysis. High levels of muscle enzymes such as creatine kinase can indicate muscle inflammation. Other blood tests can detect abnormal antibodies that indicate the presence of an autoimmune disease;
• magnetic resonance imaging (MRI). This test uses powerful magnets and a computer to create images of muscles. An MRI scan can help identify affected areas and changes in muscles;
• electromyogram (EMG). With this test, the doctor can test the muscle response to electrical nerve signals. EMG can identify muscles that have been weakened or damaged by myositis;
• muscle biopsy. This is the most accurate test for diagnosing myositis. The doctor identifies the weak muscle, makes a small incision, and removes a small sample of muscle tissue for testing. A muscle biopsy can confirm or refute the diagnosis of myositis.

There are many causes of muscle weakness and pain that are much more common than myositis. Diagnosis of myositis is a complex process. For this reason, it can be quite long.

Treatment of myositis

Treatment of myositis is always treatment of the underlying disease that caused myositis.

The inflammatory conditions that cause myositis may require treatment with drugs that suppress the immune system, including:

• prednisolone;
• azathioprine (imuran);
• methotrexate.

For myositis caused by infection (mostly viral), no specific treatment is required. Myositis caused by bacteria is rare and usually requires antibiotics to prevent the life-threatening infection from spreading.

Although acute skeletal muscle necrosis is extremely rare as a consequence of myositis, it can cause irreparable damage to the kidneys. People with acute skeletal muscle necrosis should be hospitalized for continuous, large amounts of intravenous fluids.

Drug-associated myositis is treated by simply interrupting treatment. In cases where myositis was caused by statin use, muscle inflammation usually resolves within a few weeks after stopping the drug.

Prevention

Scientists don't know exactly what causes most forms of myositis, so there are no official recommendations for preventing it.

Only infectious myositis and drug-induced myositis are potentially preventable. To prevent these diseases:

• Get an annual flu shot;
• heat process pork and other types of meat for a long time;
• never inject illegal drugs into the skin or muscles;
• If you have been prescribed any injectable medication, make sure the injection site is as clean as possible before administration;
• keep your skin clean;
• Take the lowest doses of the fewest medications needed. A routine blood test to detect muscle damage may also be helpful.

When to see a doctor

Make an appointment with your doctor if you experience the following symptoms:

• muscle weakness that does not disappear;
• a red or purple rash on the face that doesn't go away, or scaly plaques on the joints;
• muscle pain that does not go away after rest and standard painkillers;
• swelling on any muscle, especially if it is accompanied high temperature or other symptoms;
• muscle pain and weakness that begins after taking new medications.

Contact your doctor immediately if:

you have a high temperature along with muscle pain and weakness;
• the muscle feels hot, painful and tense;
• your child complains of severe pain in his leg and has difficulty walking.

The cause of rhabdomyolysis is the destruction of striated muscle cells, as a result of which myoglobin enters the blood. This negatively affects the functioning of the kidneys and disrupts metabolism in general.

The main factors that can trigger the destruction of muscle cells:

• direct injuries;
• muscle spasms;
• metabolic disorders;
• exposure to toxic substances;
• autoimmune diseases;
• infectious pathologies;
• acute necrotizing myopathy of cancer tumors.

Most often, rhabdomyolysis occurs due to direct injury to the striated muscles. The disease can be caused by:

• extensive burns;
• beatings;
• injuries resulting from road accidents or natural disasters;
• long-term surgical intervention;
• prolonged compression of tissues;
• electric shock and so on.

Pathological factors associated with prolonged muscle contractions include:

• intense training;
• epileptic seizures;
• attacks of “delirium tremens”;
• muscle spasms caused by tetanus.

Among the metabolic pathologies that can lead to rhabdomyolysis are diabetes mellitus, hypophosphatemia, as well as other electrolyte and hereditary disorders.

Toxic substances that can cause muscle tissue destruction:

• drugs – cocaine, heroin, amphetamines;
• alcohol in excessive quantities;
• combinations of drugs - statins, analgesics, antidepressants, sleeping pills, antibiotics;
• carbon monoxide;
• poison of snakes and some insects;
• mushroom poison

The main autoimmune diseases that provoke rhabdomyolysis are hereditary myopathies, sickle cell anemia, and dermatomyositis.

Infectious diseases (influenza, herpes, Epstein-Barr viruses), which are accompanied by high fever, as well as HIV, can lead to damage to muscle tissue. In addition, rhabdomyolysis can result from heat stroke, hypothermia, or prolonged immobilization.

Pathogenesis

Rhabdomyolysis develops as follows. With intensive breakdown of muscle cells, a large amount of myoglobin, a protein that carries oxygen and is found in skeletal muscles and heart tissue, enters the blood. Normally, it combines with plasma globulin and practically does not penetrate into the urine.

Due to massive release, myoglobin enters the kidneys. It is not dangerous in itself, but its structure contains an element that synthesizes free hydroxyl radicals, which have a toxic effect on the epithelium of the renal tubules.

Myoglobin combines with Tamm-Horsfall proteins in the kidneys to form solids in the nephrons that prevent normal operation urinary system. This is how kidney failure develops.

Along with this, a failure occurs in the homeostasis system. Due to the death of muscle cells, the body experiences less need for creatine. Its excess enters the blood and is transformed into creatinine. To neutralize it, active production of creatine phosphokinase begins, an enzyme that catalyzes creatine phosphate (a high-energy compound) from ATP and creatine.

Rhabdomyolysis is characterized by rapid progression of pathological processes. Injury to the muscles leads to their swelling and increased pressure on the nerve endings and surrounding tissues, as a result of which they are also damaged. In addition, disruption of fluid metabolism in cells provokes a deterioration in general blood circulation, including blood flow to the kidneys, which aggravates their condition.

Symptoms

Symptoms of rhabdomyolysis depend on the type of rhabdomyolysis. There are mild and severe forms of pathology.

In mild cases, there is muscle weakness, tenderness and swelling at the site of injury, and dark-colored urine. Sometimes these signs are absent, and the disease is detected by blood tests.

The severe form of the pathology progresses rapidly. First, local tissue swelling appears, then severe pain occurs in the affected area, movements become difficult. With extensive injuries, paralysis, shock or stroke can develop.

Due to the release of muscle cell breakdown products into the blood, the general condition deteriorates: nausea and vomiting appear. The release of myoglobin leads to the development of renal failure. Its symptoms:

• dark brown or reddish urine;
• a significant decrease in urine volume or complete absence of diuresis;
• lethargy;
• swelling of the limbs;
• irregular pulse;
• heart rhythm disturbance;
• disorientation.

Without medical care the person may fall into a coma.

Diagnostics

Diagnosis of rhabdomyolysis is carried out on the basis of examination of the patient and analysis of his complaints. Highest value have the results of blood and urine tests.

Blood tests show:

• changes in electrolyte levels - the concentration of potassium and phosphorus increases, and calcium decreases;
• increased levels of muscle enzymes;
• changes in the concentration of creatine kinase - an increase in the first hours after injury and a gradual decrease over 1-3 days.

Urinalysis for rhabdomyolysis shows the presence of myoglobin, that is, myoglobinuria.

Additionally, instrumental studies are carried out - electrocardiography and radiography (to assess damage).

Treatment

Severe rhabdomyolysis is treated in a hospital setting. ECG readings are constantly monitored, as well as urine pH levels, electrolytes and other markers. Therapy is aimed at reducing the concentration of toxins, normalizing water and electrolyte balance and activating fluid movement in the kidneys.

Directions of treatment:

• administration of furosemide and mannitol;
• intravenous infusion of saline solution;
• plasma transfusion (for intravascular coagulation);
• dialysis (for acute renal failure);
• surgical intervention (for muscle necrosis caused by pinching).

In addition, a diet low in protein and potassium is prescribed.

Forecast

Different types of rhabdomyolysis have different prognoses. With a mild form of the disease, in most cases, complete recovery occurs without subsequent relapses. If acute renal failure develops and the patient does not receive adequate treatment, the chance of death is 20%.

Prevention

Measures to prevent rhabdomyolysis:

• timely treatment of muscle injuries;
• compliance with the drinking regime during physical activity, after injuries and during infectious diseases;
• moderate intensity of sports;
• drug withdrawal;
• judicious use of medications.

The consequences of muscle tissue injuries are well known to people involved in professional sports. Those who receive constant physical activity and have an idea of ​​their benefits and harms are familiar with the concept of “rhabdomyolysis.” The symptoms of this disease are very serious. Despite its mild course, the pathology can lead to dire consequences for the body. Rhabdomyolysis - what is it? Not only doctors, but also any qualified coach in each sport can answer this question. The pathology is very dangerous and, at a severe stage, can lead to However, if it is detected on time, a complete cure is possible.

Rhabdomyolysis disease - what is it?

This pathology is most often observed with muscle injuries. It involves the destruction of tissue and the release of harmful substances into the blood. This is how you can briefly describe the essence of the syndrome called rhabdomyolysis. What it is will become more clear if you study the process of development of the disease and its consequences for the body. It should be remembered that not every injury or physical activity leads to illness. Rhabdomyolysis is a syndrome in which muscle tissue is destroyed. Due to the destruction of skeletal muscles, a substance enters the blood that should not normally be there. This is the protein myoglobin. It is an essential component for muscles. Normally it is inactivated by the kidneys and does not harm the body. But with the destruction and breakdown of muscles, its amount in the blood reaches a high concentration. As a result, myoglobin circulates throughout the body for a long time, releasing nephrotoxic substances. These substances are extremely harmful to the tissue of the renal tubules. Based on this, we can answer the question: “Rhabdomyolysis - what is it and why is it dangerous?” In addition to muscle destruction, this syndrome can lead to such a serious condition as: If assistance is not provided in a timely manner, acute renal failure can cause death.

Rhabdomyolysis: causes of the disease

There are 2 groups of reasons leading to the development of rhabdomyolysis. In the first case, these are injuries. These do not include minor impacts on the muscles (bruises). Among the damaging factors are:

1. Serious accidents.
2. Burns that are large in area and depth (reaching the muscle layer).
3. The effect of electric current on the body.
4. Violent actions leading to muscle injuries.
5. Toxicosis caused by traumatic shock.
6. Long-term surgical interventions.

Another cause of rhabdomyolysis is strong contractions of muscle tissue. They can be caused by heavy physical activity (unusual for the body) and convulsive syndrome.

In addition, there are other factors that lead to rhabdomyolysis. They are less common, but can still cause the development of this pathology. These include electrolyte imbalance, bacterial and viral diseases, as well as drug intoxication. All these reasons contribute to a lack of ATP. As is known, it is the deficiency of this substance that affects the development of rhabdomyolysis. A small amount of ATP causes a decrease in electrolytes in the body. These include substances such as calcium, phosphates and potassium. A deficiency of these substances is observed in heatstroke, sunstroke, and hypothermia. In some cases, a person’s prolonged stay in a supine position—immobilization—leads to the destruction of muscle tissue.

Mechanism of development of rhabdomyolysis

The pathogenesis of rhabdomyolysis depends on what caused the destruction of skeletal muscles. If the muscles have been damaged by traumatic effects or metabolic disorders, cell swelling occurs. This happens due to the entry of fluid from the surrounding space into the myocyte membrane. Due to this disorder, the cells swell and become large. The altered myocytes put pressure on surrounding tissues and nerve fibers. Thus, blood flow to healthy muscle cells is disrupted, which leads to their destruction. Due to the destruction of skeletal muscles, the protein myoglobin is released. In general, this substance is not toxic to the body. However, protein can cause kidney problems. This happens as follows: myoglobin binds to a substance found in kidney cells. This connection gives rise to solid formations that interfere with blood flow. In addition, myoglobin has nephrotoxic effects.

Clinical signs of pathology

There are severe and mild symptoms of rhabdomyolysis. In the first case, muscle destruction syndrome is combined with renal failure. Mild rhabdomyosis is not aggravated by acute renal failure. Clinical manifestations of the pathology include:

1. Muscle weakness.
2. Darkening of the color of urine. This sign indicates renal dysfunction and is a diagnostic criterion for rhabdomyolysis.
3. Swelling and tenderness of skeletal muscles.

Upon joining, the patient's condition deteriorates sharply. Symptoms of acute renal failure include:

1. Swelling of the limbs.
2. Little urine output, up to its absence.
3. Compartment syndrome. Occurs due to swelling of muscle tissue. May lead to compression of vital organs. Symptoms of this disorder are: shortness of breath, decreased blood pressure, shock.
4. Tachycardia, subsequently - thread-like pulse.
5. Electrolyte imbalance.
6. Coma.

Diagnostic criteria for rhabdomyolysis

The disease can be suspected based on the following criteria: previous injury to muscle tissue, soreness and swelling of the muscles, darkening of the urine. These symptoms allow a preliminary diagnosis of rhabdomyolysis to be made. The disease is always accompanied by changes in the blood and urine. The diagnosis is confirmed if laboratory tests reveal the following abnormalities:

1. Elevated levels of creatine phosphokinase.
2. The appearance of myoglobin in the blood.
3. Increased phosphorus and potassium levels, decreased calcium ions.
4. With the development of renal failure - a large amount of creatinine and urea.
5. Myoglobinuria (the appearance of protein in the urine).

In addition, changes are observed on the ECG (expansion of ventricular complexes, appearance of T-waves). With severe compartment syndrome, there may be damage to internal organs and bones. Therefore, to diagnose disorders, it is necessary to conduct radiography.

Treatment methods for rhabdomyolysis

Help for the patient should begin immediately, immediately after the diagnosis of rhabdomyolysis has been made. Treatment of the pathology should be carried out in a hospital, since in a hospital setting it is possible to monitor the level of electrolytes. To cleanse the body, rehydration is performed. In case of severe rhabdomyolysis, saline solution is required. Correction of water-salt and electrolyte metabolism is also important. To normalize diuresis, diuretics Furosemide or Mannitol are administered. In extremely severe cases, hemodialysis is used. If muscle pressure reaches more than 30 mm. rt. Art., surgical excision of tissue is necessary - fasciotomy. This is the only way to stop further compression of the organs.

Possible complications of pathology

You should know that timely assistance for mild pathology will help stop rhabdomyolysis. Photos of patients suffering from this syndrome are presented in abundance on the pages of relevant medical information resources. Knowing what the affected muscles look like is very important for people engaged in heavy physical labor. If rhabdomyolysis is suspected, laboratory tests of blood and urine should be performed. If the disease has developed to a severe degree, it is dangerous due to the following complications:

1. Damage to organs and tissues. Occurs due to compartment syndrome.
2. Acute renal failure.
3. DIC syndrome. Occurs due to poor blood clotting. In severe cases it leads to death.

Prognosis for life with rhabdomyolysis

The prognosis depends on the severity of the pathology. At the initial stage, the disease responds well drug treatment. Relapses are observed only in case of repeated traumatization. If the pathology has reached a severe degree, the prognosis is less favorable. However, cure is possible with a combination drug therapy and surgical intervention. If AKI develops, the mortality rate is 20%.

Acute skeletal muscle necrosis- a condition in which skeletal muscle tissue is damaged (Greek: rhabdo- striped μυς myo- muscle), breaks (Greek: –lysis) fast. The breakdown products of damaged muscle cells are released into the bloodstream; some of them, such as the protein myoglobin, are harmful to the kidneys and can lead to kidney failure. The severity of the symptoms, which may include muscle pain, vomiting and confusion, depends on the extent of the muscle damage and whether kidney failure develops. Muscle damage can be caused by physical factors (eg, crush injury, strenuous exercise, medications, drug abuse and infections). Some people have an inherited muscle disorder that increases the risk of acute skeletal muscle necrosis. Diagnosis is usually made with blood tests and urinalysis. The mainstay of treatment is generous amounts of intravenous fluids, but may include dialysis or hemofiltration in more severe cases.

Acute skeletal muscle necrosis and its complications are significant problems for those injured in disasters such as earthquakes and bombings. Relief efforts in areas hit frequently by earthquakes include teams of doctors with the skills and equipment to treat survivors with acute skeletal muscle necrosis. The disease was first described in the 20th century, and important discoveries regarding its mechanism were made during the London Blitz in 1941. Horses can also suffer from acute skeletal muscle necrosis from a variety of causes.

Signs and signs

Symptoms of acute skeletal muscle necrosis depend on its severity and whether kidney failure develops. More mild forms may not cause muscle signs, and diagnosis is based on abnormal blood tests in the context of other problems. More severe acute skeletal muscle necrosis is characterized by muscle pain, tenderness, weakness, and swelling of the affected muscles. If the swelling is very rapid, as can happen after someone is freed from a collapsed building, the movement of fluid from the bloodstream into the injured muscle can cause low blood pressure and shock. Other symptoms are vague and arise either from the effects of a muscle disorder or from the condition that originally led to the muscle disorder. The release of muscle tissue components into the bloodstream causes electrolyte disturbances, which can lead to nausea, vomiting, confusion, coma or abnormal heart rate and rhythm. The urine may be dark, often described as "tea-colored", due to the presence of myoglobin. Kidney damage can give rise to reduced or absent urine production, usually 12 to 24 hours after the initial muscle damage.

Swelling of the injured muscle sometimes leads to compartment syndrome - compression of surrounding tissues, such as nerves and blood vessels, in the same fascial compartment - leading to loss of blood supply and damage or loss of function in the part(s) of the body supplied by these structures. Signs of this complication include pain or decreased sensation in the affected limb. The second recognized complication is disseminated intravascular coagulation (DIC), a serious disruption in blood clotting that can lead to uncontrollable bleeding.

Causes

Any form of muscle injury of sufficient severity can cause acute necrosis of skeletal muscle. Multiple causes may be present simultaneously in one person. Some have an underlying muscle disorder, usually hereditary in nature, that makes them more susceptible to acute skeletal muscle necrosis.

Common and important reasons

Genetic predisposition

Recurrent acute necrosis of skeletal muscle may result from intrinsic muscle enzyme deficiencies, which are usually inherited and often appear during childhood. Many structural muscle pathologies feature episodes of acute skeletal muscle necrosis that are caused by exercise, general anesthesia or any of the other causes of acute skeletal muscle necrosis mentioned above. Inherited muscle diseases and infections together cause the majority of acute skeletal muscle necrosis in children.

The following hereditary diseases of muscle energy supply can cause ongoing and usually exertional acute necrosis of skeletal muscle:

• Glycolysis and glycogenolysis defects: McArdle disease, phosphofructokinase deficiency, glycogen diseases VIII, IX, X and
• Lipid metabolism defects: carnitine palmitoyltransferase I and II deficiencies, deficiency of acyl CoA dehydrogenase subtypes (LCAD, STAURID, MCAD, VLCAD, 3-hydroxyacyl-coenzyme dehydrogenase deficiency), thiolase deficiency
• Chromosomal myopathies: deficiency of succinate dehydrogenase, cytochrome c oxidase and

• Others: glucose-6-phosphate dehydrogenase deficiency, myoadenylate deaminase deficiency and muscular dystrophies

Mechanism

Damage to skeletal muscle can take many forms. Crush and other bodily injuries harm muscle cells directly or interfere with blood supply, while non-physical causes interfere with muscle cell metabolism. When damaged, muscle tissue quickly fills with fluid from the bloodstream, including sodium ions. The tumor itself can result in the destruction of muscle cells, but those cells that survive undergo various destructions that lead to a rise in intracellular calcium ions; accumulation of calcium outside the sarcoplasmic reticulum leads to continuous muscle contraction and depletion of ATP, the main carrier of energy in the cell. ATP depletion can itself lead to an uncontrolled calcium influx. Constant contraction of the muscle cell leads to disruption of intracellular proteins and cell disintegration.

Behind the unrest

If underlying muscle pathology is suspected, for example if there is no obvious explanation or there have been multiple episodes, further investigations may need to be performed. During the attack low levels Carnitine levels in the blood and high levels of acylcarnitine in the blood and urine may indicate a defect in lipid metabolism, but these abnormalities return to normal during recovery. Other tests may be used at that stage to demonstrate these disorders. Glycolysis disorders can be detected by various means, including measuring lactate after exercise; failure of lactate to rise may be indicative of a disorder in glycolysis, while an exaggerated response is typical of mitochondrial diseases. Electromyography (EMG) can show specific patterns in certain muscle pathologies; for example, McArdle disease and phosphofructokinase deficiency show a phenomenon called cramp-like contracture. There are genetic tests available for many inherited muscle diseases that predispose to myoglobinuria and acute skeletal muscle necrosis.

Other animals

Acute skeletal muscle necrosis is recognized in horses. Horses can develop many muscle diseases, many of which can progress to acute skeletal muscle necrosis. Of these, some cause isolated bouts of acute necrosis of skeletal muscle (eg, dietary deficiency in vitamin E and selenium, poisoning associated with grazing or agricultural poisons such as organophosphates), while others predispose to exertional acute necrosis of skeletal muscle (eg, hereditary equine polysaccharide storage myopathy conditions). 5-10% of Thoroughbreds and some standard horses suffer from the horse exertional condition Acute Necrosis of the Skeletal Muscles; no specific cause has been identified, but an underlying disorder of muscle calcium regulation is suspected.

Horses exposed to acute skeletal muscle necrosis may also occur in outbreaks; they have been reported in many European countries, and later in Canada, Australia and the United States. This was referred to as "atypical myopathy" or "myoglobinuria of unknown etiology". No single cause has yet been found, but various mechanisms have been proposed and a seasonal pattern has been observed. Found very high levels creatine kinase, and the mortality rate for this condition is 89%.

The human body has 650 muscles, which define one third and half of our body. They not only allow us to stand, walk, sit and talk, but also to suck in and expel air from the lungs, move blood through your body, and guide the eyes and move food through the digestive tract.

By it's nature human body adapts to constant physical activity. A good example in this regard, it appears that astronauts who, after some time in zero-gravity conditions (which do not have their bodies to counteract gravity) quickly showed signs of muscle weakness, high blood pressure and brittle bones - a striking demonstration of how lack of physical activity harms our body.

Another typical example, in which during forced immobilization (if the patient is in bed) up to 25% reduction can be observed within the first 48 hours muscle mass.

The above is for viewing only one - regular exercise is vital for our entire body, it will not only strengthen muscles, but build and maintain bone density, protect joints and improve posture, flexibility and endurance http://morphme.ru/ where You can order a mask. .

What do we know about rhabdomyolysis?

This is an extremely severe and rarely life-threatening disease which leads to the degradation of striated muscle tissue (so-called myolysis) and the release of muscle protein (mioglobulin) in the blood. The insidious thing about this disease is that in some cases it can occur without showing any symptoms.

The most commonly observed symptoms are:

• pain in skeletal muscles
• stiffness, general muscle weakness
• increased levels of creatine enzymes, CPK levels are ten times higher than established reference values, and darker urine color due to protein units. On the other hand, excessive myoglobulin amounts can lead to blockage of the renal tubules and subsequent kidney failure.

What are the main factors of rhabdomyolysis?

• Muscle injury or injury;
• Very strenuous exercise (such as a marathon);
• Heavy muscles due to prolonged arrest;
• Various inflammatory muscle diseases (myositis, dermatomyositis, polymyositis);
• Severe burns;
• Prolonged coma;
• Low levels of electrolytes in the blood;
• Prolonged hypothermia (low body temperature);
• Narcotic or alcohol intoxication, as well as the use of various medicines(statins - for the treatment of high cholesterol, drugs for the treatment of Parkinson's, anesthesia drugs, HIV drugs) like. A typical example is combining grapefruit juice with statins. This combination can be deadly. Some of the ingredients in sweet and bitter fruits and drugs compete for liver enzymes. Subsequently, plasma levels above statins may lead to rhabdomyolysis and acute renal failure.
• Other viruses and some bacteria;
• Poison splashed in the body due to a snake bite (in particular, the true condition was seen mainly in Africa and South America);
• Hereditary predisposition.

What complications may arise?

Firstly, of course, kidney failure. On the other hand, established rhabdomyolysis occurs in the so-called "syndrome" - where every muscle damage occurs swelling, which leads to impaired blood circulation, which potentially threatens the affected tissue. This syndrome is most often seen after injury to the calf muscle or abdominal wall, often requiring surgery.

Rhabdomyolysis may also cause disturbances in the amount of electrolytes in the blood. Once muscle is damaged, the affected muscle cells can release large amounts of potassium and phosphorus into the blood, leading to hyperkalemia and hyperphosphatemia.

The battle against a nasty disease can't be won?

Rhabdomyolysis is a condition that is not particularly affected by preventive measures taken before it occurs. And this is understandable, given the factors causing it.

We must not forget that the muscles and bones that form the frame are active, living tissue that throughout our lives is constantly renewed and restores order in our body, strong and energetic. To do this, the body needs not only a healthy shake, including all the necessary vitamins and minerals, but also movement from regular exercise.

It's easy to take healthy muscles, bones and joints for granted, but if you don't eat right and don't spend enough time exercising, the health of these vital tissues will soon begin to deteriorate. Food that provides the necessary "fuel" from the body feels the need for regular sports to keep it in a constant state, ready for any challenge.

Although we cannot completely protect our body from conditions such as rabdomilolizata, it can certainly provide significant prevention not only from diseases of the musculoskeletal system, but those involving other organs and systems.