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Myoglobinuria

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Myoglobinuria describes the presence of myoglobin (a muscle protein) in the urine .

Myoglobin is released if there is muscle injury or necrosis (rhabdomyolysis).

Causes of myoglobinuria include:

  • trauma
  • electrocution
  • ischaemia
  • immobility
  • excessive exercise
  • myositis
  • drugs e.g. statins, fibrates
  • toxins e.g. snake bite, carbon monoxide, alcohol, ecstasy
  • inherited muscle disorders e.g. McArdle's disease
  • malignant hyperpyrexia
  • neuroleptic malignant syndrome
  • metabolic causes e.g. hypokalaemia, hypophosphataemia
  • coma

Clinical features:

  • may be asymptomatic - depending on cause
  • nospecific symptoms e.g. muscle tenderness, pain or swelling

Investigations:

  • dipstick urine - positive for blood but negative for red blood cells on microscopy
  • blood tests - increased creatinine, increased urea, increased potassium, reduced calcium, increased phosphate, increased urate, increased CK, increased LDH

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