Myoglobinuria: Difference between revisions

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	Myoglobinuria;
	Model of helical domains in myoglobin.

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Revision as of 15:38, 7 November 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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

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

Causes by Organ System

Cardiovascular	Myocardial infarction, Myocarditis
Chemical/Poisoning	Haff disease, Snake bite , Venoms
Dental	No underlying causes
Dermatologic	Dermatomyositis
Drug Side Effect	Barbiturates, Carbenoxolone, Diamorphine, Fibrate, Malignant hyperpyrexia, Neuroleptic malignant syndrome, Statins, Trabectedin
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	Heat stroke
Gastroenterologic	No underlying causes
Genetic	Brody myopathy, Carnitine palmitoyltransferase 1 deficiency, Carnitine palmitoyltransferase 2 deficiency, Familial paroxysmal rhabdomyolysis, Glycogen disease type v, Myopathy with deficiency of succinate dehydrogenase and aconitase, Phosphoglycerate kinase deficiency, Phosphogylcerate mutase 2 deficiency, Very long-chain acyl-coa dehydrogenase deficiency
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	Brody myopathy, Compartment syndrome, Dermatomyositis, Polymyositis, Rhabdomyolysis
Neurologic	Choreoathetosis, Seizures
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes]
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Hypokalaemia, Hypophosphataemia
Rheumatology/Immunology/Allergy	Dermatomyositis, Polymyositis
Sexual	No underlying causes
Trauma	Burns, Crush syndrome, Electric shock, Trauma
Urologic	No underlying causes
Miscellaneous	Exercise, Meyer-betz disease

Causes in Alphabetical Order

Differential diagnosis of causes of myoglobinuria

Trauma, vascular problems, venoms, certain drugs and other situations can destroy or damage the muscle, releasing myoglobin to the circulation and thus to the kidneys.

Miscellaneous syndromes

Rhabdomyolysis
Meyer-Betz disease

Autosomal recessive conditions

Glycogenosis type 5
Phosphogylcerate mutase 2 deficiency

Cardiac and vascular conditions

Myocarditis

Inflammatory conditions

Myositis

Trauma, mechanical and physical conditions

Differentiating myoglobinuria from hemoglobinuria

After centrifuge, the serum of myologinuria is clear, where the serum of hemoglobinuria after centrifuge is pink.

Template:WH Template:WS

@@ Line 15: / Line 15: @@
 ==Causes==
 ===Causes by Organ System===
+{|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 ]], [[Venoms]]
+|-
+|-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"| [[Brody myopathy]], [[Carnitine palmitoyltransferase 1 deficiency]], [[Carnitine palmitoyltransferase 2 deficiency]], [[Familial paroxysmal rhabdomyolysis]], [[Glycogen disease type v]], [[Myopathy with deficiency of succinate dehydrogenase and aconitase]], [[Phosphoglycerate kinase deficiency]], [[Phosphogylcerate mutase 2 deficiency]], [[Very long-chain acyl-coa 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"|  [[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]], [[Meyer-betz disease]]
+|-
+|}
 ===Causes in Alphabetical Order===
 ==Differential diagnosis of causes of myoglobinuria==