Drug-Induced Rhabdomyolysis

Abstract

The syndrome of rhabdomyolysis is the result of skeletalmuscle injury that alters the integrity of the sarcolemmaand leads to the eventual release of intracellular contentsinto the plasma. The causes are diverse, and includemuscle trauma (for instance, from vigorous exercise, crushinjuries, battering, or seizures), inadequate bloodperfusion, heat stroke, electrolyte imbalance, hereditaryenzyme deficiencies, infections and ingestion of drugs andtoxins. Various serious medical disorders, particularlythose resulting in states of disordered energy production,are also associated with rhabdomyolysis.In general, drug toxicity involves organs, such as thekidney, liver, gastrointestinal tract and the central nervoussystem, with skeletal muscle being usually less readilyaffected. Although drug-induced rhabdomyolysis wasuncommon in the past, it is no longer rare, due to theintroduction of more and increasingly potent drugs intoclinical practice.The incidence of drug-induced rhabdomyolysis isuncertain, largely because most of it is unreported.Similarly, the mortality rates are unknown. However, ithas been suggested that rhabdomyolysis from all causesleads to 5%-25% of cases of acute renal failure.