Acute Rhabdomyolysis Associated with Alcoholic Necrotizing Myopathy

 

Clinical features:

(1) The patient has a history of recent alcohol intake, often involving a binge.

(2) The patient develops acute muscle pain with cramping.

(3) The patient's urine is noted to be red.

(4) The patient may have a past history of a similar episode.

(5) Affected muscles may be swollen.

(6) Acute renal failure may develop if myoglobinuria severe.

 

Laboratory findings:

(1) markedly elevated serum creatine kinase (CK)

(2) myoglobinuria

(3) elevated serum creatinine if renal failure develops

(4) myonecrosis on biopsy of an affected muscle, ranging from mild to massive

 

Differential diagnosis:

(1) other causes of acute rhabdomyolysis

(2) acute pressure necrosis if unconscious and immobile for a prolonged period

(3) deep vein thrombosis

(4) blunt trauma

(5) compartment syndrome