Myoglobinuria and Strenuous Exercise

Abstract

<h3>To the Editor:—</h3> Myoglobinuria represents the liberation of the intracellular contents of skeletal muscle resulting in concentration of the pigment in the plasma above the renal threshold. In man the appearance of this pigmented substance in the urine is associated with blunt trauma, electrical burns, arterial occlusion, acute barbiturate overdosage, and McArdles disease or myopathy due to chronic alcoholism.¹It also occurs in primary paroxysmal idiopathic myoglobinuria,^{1, 2}in epidemic myoglobinuria ( Haff's Disease), muscular dystrophy,¹and has been reported in the anterior tibial syndrome and acute polymyositis.³Cases of myoglobinuria are described in military recruits following strenuous exercise.⁴The present case resulted from localized muscular injury associated with severe muscular strain. An 18-year-old white man was admitted with the complaint of left upper leg pain and "red urine." His illness dated three weeks prior to admission with vague pain and weakness in the left upper