Cabral, B. M. I., Edding, S. N., Portocarrero, J. P., & Lerma, E. V. (2020). Rhabdomyolysis. Disease-A-Month, 66(8), 101015. DOI: 10.1016/j.disamonth.2020.101015
The authors of this review explored several aspects crucial for understanding rhabdomyolysis — etiology (common causes), clinical manifestations (symptoms), and effective methods of rhabdomyolysis diagnosis, prevention, and treatment. Destruction of the sarcolemmal membrane and release of intracellular components into the systemic circulation has been defined as a central cause of the pathophysiology. The authors have also provided a well-structured diagnostic approach and detailed graphical algorithms for fluid resuscitation and rhabdomyolysis treatment. They have also determined the serum creatine kinase (CK) level of at least five times higher than the upper limit of normal as a definitive marker of rhabdomyolysis. In addition, the authors developed a list of essential tests for prompt recognition of rhabdomyolysis, such as serum myoglobin test and urinalysis. Another important takeaway from the article is the importance of early and aggressive fluid replacement using the crystalloid solution for preventing and treating AKI (Acute Kidney Injury). In addition, the authors found no established benefit of using mannitol or giving bicarbonate infusion for treating rhabdomyolysis. Overall, the article confirmed a positive prognosis of rhabdomyolysis treatment in case of early and aggressive medical intervention.
Disease-A-Month journal is published by Elsevier, one of the most influential publishing companies in scientific and medical fields. This monthly publication provides in-depth coverage of particular diseases, making possible understanding of such aspects as pathophysiology, clinical features, diagnostic techniques, and treatment approaches. The lead author of the article on rhabdomyolysis, Dr. Brian Michael I. Cabral, is an accomplished medical professional. He serves as a Clinical Associate Professor at the Department of Medicine, Section of Nephrology of the Philippine General Hospital. In addition, the authors did not declare any financial or professional conflicts of interest, which adds to the credibility and impartiality of their article.
Cervellin, G., Comelli, I., Benatti, M., Sanchis-Gomar, F., Bassi, A., & Lippi, G. (2017). Non-traumatic rhabdomyolysis: Background, laboratory features, and acute clinical management. Clinical Biochemistry, 50(12), 656-662. DOI: 10.1016/j.clinbiochem.2017.02.016
This article presents a complex take on non-traumatic rhabdomyolysis, starting from its historical background and ending with clinical management. The authors defined rhabdomyolysis as a rapid breakdown of striated or skeletal muscle, characterized by the rupture of muscle fibers and the release of cell degradation products into the bloodstream. They have also provided a list of additional rhabdomyolysis causes, including hypoxic, physical, chemical, or biological factors. The article also formulated a triad of the most common symptoms associated with rhabdomyolysis: muscle pain, weakness, and dark urine. In addition, the authors listed biomarkers of muscle injury, measuring of which is essential for laboratory diagnoses, such as creatine kinase and myoglobin. Furthermore, targeted interventions to manage the underlying cause of rhabdomyolysis combined with an infusion of fluids were suggested as an essential method of clinical management in emergency departments. Overall, the authors underscored the frequent ineffectiveness of clinical prevention strategies rhabdomyolysis due to the problems arising in recognition of triggering factors. In this regard, the authors deemed expanding the knowledge on rhabdomyolysis triggering factors pivotal for the clinical management of the patients. Given the dangerous clinical consequences of rhabdomyolysis in terms of morbidity and mortality, the authors urged for prompt management of precipitating conditions.
Clinical Biochemistry is an official journal of the Canadian Society of Clinical Chemists, which specializes in clinical chemistry, molecular biology, and laboratory medicine. In addition, this journal is published by Elsevier, which adds extra credibility to the scholarly sources taken from it. All authors who wrote the article on non-traumatic rhabdomyolysis are experienced medical professionals, including Gianfranco Cervellin, the lead author, who works at the Emergency Department of Academic Hospital of Parma, Italy. Furthermore, the authors have not declared any conflicts of interest, financial or otherwise.
Husain, R., Corcuera-Solano, I., Dayan, E., Jacobi, A. H., & Huang, M. (2020). Rhabdomyolysis as a manifestation of a severe case of COVID-19: A case report. Radiology Case Reports, 15(9), 1633-1637. DOI: 10.1016/j.radcr.2020.07.003
This article explores rhabdomyolysis as a severe complication related to the case of COVID-19, providing evidence that COVID-19 can affect other organ systems, including renal. The authors made a conclusion of rhabdomyolysis being secondary to COVID-19 based on three points: worsening muscular pain, elevated CK levels, and elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Furthermore, radiological images provided in the article serve as additional support for the findings and an illustration of rhabdomyolysis case development. Overall, the reported case gives valuable insight for the radiologists and other medical professionals in the frontline. The reported findings confirm a multifaceted nature of the COVID-19 and the importance of examining such symptoms as muscular pain and fatigue since they might be pointing at the developing rhabdomyolysis.
Radiology Case Reports journal is published by Elsevier under the copyright license from the University of Washington, one of the oldest universities on the U.S. West Coast. The articles published in this journal feature diagnostic imaging from the actual medical practice. As a result, it serves as a valuable source of information on various categories, including the musculoskeletal system, cardiovascular system, central nervous system, chest, spine, and many others. The article on rhabdomyolysis case related to COVID-19 was published by a team of radiologists from the Mount Sinai Health System, a significant hospital network in New York City. Rola Husain, the lead author, holds Bachelor of Medicine, Bachelor of Surgery, and Bachelor of Obstetrics degrees. In addition, the authors declared no conflicts of interest or any specific grants or other sources of external funding for their research.