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'''For patient information, click [[Xyz (patient information)|here]]'''
{{Myoglobinuria}}
{{Infobox_Disease |
{{Infobox_Disease |
  Name = {{PAGENAME}} |
  Name = {{PAGENAME}} |
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  Caption = Model of helical domains in myoglobin. |
  Caption = Model of helical domains in myoglobin. |
}}
}}
{{SI}}
{{CMG}}; {{AE}} {{AKS}}; {{VSKP}}
{{CMG}}
 
 
==[[Myoglobinuria overview|Overview]]==


==Overview==
==[[Myoglobinuria historical perspective|Historical Perspective]]==
Myoglobinuria is the presence of [[myoglobin]] in the urine, usually associated with [[rhabdomyolysis]] or muscle destruction. Myoglobin is present in [[muscle]] cells as a reserve of [[oxygen]].


==Pathophysiology==
==[[Myoglobinuria classification|Classification]]==
Under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of renal problems, it can occlude the renal filtration system leading to acute tubular necrosis and acute [[renal insufficiency]].
==Causes==
===Common Causes===
*[[Burns]]
*[[Crush syndrome]]
*[[Electrolyte imbalanc such as hypokalaemia and hyperphosphotemia]]
*[[Exercise]]
*[[Heat stroke]]
*[[Medication such as statins and fibrates]]
*[[Rhabdomyolysis]]
*[[Seizures]]
*[[Trauma]]


===Causes by Organ System===
==[[Myoglobinuria pathophysiology|Pathophysiology]]==
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Myocardial infarction]], [[Myocarditis]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Haff disease]], [[Snake bite ]], [[Venom]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Dermatomyositis]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Barbiturates]], [[Carbenoxolone]], [[Diamorphine]], [[Fibrate]], [[Malignant hyperpyrexia]], [[Neuroleptic malignant syndrome]], [[Statins]], [[Trabectedin]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Heat stroke]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Calcium ATPase|Brody myopathy]], [[Carnitine palmitoyltransferase 1 deficiency]], [[Carnitine palmitoyltransferase 2 deficiency]], [[Familial paroxysmal rhabdomyolysis]], [[Glycogen storage disease type V]], [[Succinate dehydrogenase|Myopathy with deficiency of succinate dehydrogenase and aconitase]], [[Phosphoglycerate kinase|Phosphoglycerate kinase deficiency]], [[Phosphoglycerate mutase|Phosphogylcerate mutase 2 deficiency]], [[Very long-chain acyl-coenzyme A dehydrogenase deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|  No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"|  [[Calcium ATPase|Brody myopathy]], [[Compartment syndrome]], [[Dermatomyositis]], [[Polymyositis]], [[Rhabdomyolysis]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Choreoathetosis]], [[Seizures]]  
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Hypokalaemia]], [[Hypophosphataemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|  [[Dermatomyositis]], [[Polymyositis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Burns]], [[Crush syndrome]], [[Electric shock]], [[Trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Exercise]], [[Myopathy|Meyer-betz disease]]
|-
|}


===Causes in Alphabetical Order===
==[[Myoglobinuria causes|Causes]]==
{{columns-list|3|
 
==[[Myoglobinuria differential diagnosis|Differentiating Myoglobinuria from other Diseases]]==
*[[Barbiturates]]
 
*[[Calcium ATPase|Brody myopathy]]
==[[Myoglobinuria epidemiology and demographics|Epidemiology and Demographics]]==
*[[Burns]]
 
*[[Carbenoxolone]]
==[[Myoglobinuria risk factors|Risk Factors]]==
*[[Carnitine palmitoyltransferase 1 deficiency]]
*[[Carnitine palmitoyltransferase 2 deficiency]]
*[[Choreoathetosis]]
*[[Compartment syndrome]]
*[[Crush syndrome]]
*[[Dermatomyositis]]
*[[Diamorphine]]
*[[Electric shock]]
*[[Exercise]]
*[[Familial paroxysmal rhabdomyolysis]]
*[[Fibrate]]
*[[Glycogen storage disease type V]]
*[[Haff disease]]
*[[Heat stroke]]
*[[Hypokalaemia]]
*[[Hypophosphataemia]]
*[[Malignant hyperpyrexia]]
*[[Myopathy|Meyer-Betz disease]]
*[[Myocardial infarction]]
*[[Myocarditis]]
*[[Succinate dehydrogenase|Myopathy with deficiency of succinate dehydrogenase and aconitase]]
*[[Neuroleptic malignant syndrome]]
*[[Phosphoglycerate kinase|Phosphoglycerate kinase deficiency]]
*[[Phosphoglycerate mutase|Phosphoglycerate mutase deficiency]]
*[[Polymyositis]]
*[[Rhabdomyolysis]]
*[[Seizures]]
*[[Snake bite ]]
*[[Statins]]
*[[Trabectedin]]
*[[Trauma]]
*[[Venom]]
*[[Very long-chain acyl-coenzyme A dehydrogenase deficiency]]
}}


==Differential diagnosis of causes of myoglobinuria==
==[[Myoglobinuria screening|Screening]]==
[[Physical trauma|Trauma]], vascular problems, [[venom]]s, certain drugs and other situations can destroy or damage the muscle, releasing myoglobin to the circulation and thus to the kidneys.


Miscellaneous syndromes
==[[Myoglobinuria natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* [[Rhabdomyolysis]]
* [[Myopathy|Meyer-Betz disease]]
Autosomal recessive conditions
* [[Glycogen storage disease type V]]
* [[Phosphoglycerate mutase|Phosphogylcerate mutase 2 deficiency]]
Cardiac and vascular conditions
* [[Myocarditis]]
Inflammatory conditions
* [[Myositis]]
Trauma, mechanical and physical conditions
* [[Burns]]
* [[Crush syndrome]]


==Differentiating myoglobinuria from [[hemoglobinuria]]==
==Diagnosis==
After centrifuge, the serum of myologinuria is clear, where the serum of hemoglobinuria after centrifuge is pink.
[[Myoglobinuria diagnostic study of choice|Diagnostic study of choice]] | [[Myoglobinuria history and symptoms|History and Symptoms]] | [[Myoglobinuria physical examination|Physical Examination]] | [[Myoglobinuria  laboratory findings|Laboratory Findings]] | [[Myoglobinuria electrocardiogram|Electrocardiogram]] | [[Myoglobinuria x ray|X-Ray Findings]] | [[Myoglobinuria echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Myoglobinuria CT scan|CT-Scan Findings]] | [[Myoglobinuria MRI|MRI Findings]] | [[Myoglobinuria other imaging findings|Other Imaging Findings]] | [[Myoglobinuria other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
[[Myoglobinuria medical therapy|Medical Therapy]] | [[Myoglobinuria surgery|Surgery]] | [[Myoglobinuria primary prevention|Primary Prevention]] | [[Myoglobinuria  secondary prevention|Secondary Prevention]] | [[Myoglobinuria cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Myoglobinuria future or investigational therapies|Future or Investigational Therapies]]


{{WH}}
==Case Studies==
{{WS}}
[[Myoglobinuria case study one|Case #1]]


[[Category:Disease]]
[[Category: (name of the system)]]
[[Category:Blood tests]]
[[Category:Urine tests]]

Latest revision as of 20:04, 15 August 2018

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Myoglobinuria
Model of helical domains in myoglobin.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.; Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]


Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Myoglobinuria from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1