Myoglobinuria diagnostic study of choice
Acute renal insufficiency (elevated BUN and creatinine levels) is a sequel of severe myoglobinuria in which the globulin precipitates and blocks the urinary tubules. [1]
Although both myoglobinuria and hemoglobinuria may cause a tea-colored appearance of the urine, and both can cause positive results on the urine dipstick for blood, myoglobinuria can be differentiated from hemoglobinuria by performing the following:
- Myoglobinuria is brown, and only a few RBCs are present in the urine.
- Red or brown urine with a negative dipstick result for blood indicates a dye in the urine. [2]
Study of choice
- There is no single diagnostic study of choice for the diagnosis of [[myoglobinuria], but myoglobinuria can be diagnosed based on creatine kinase (CK) levels to assess for rhabdomyolysis.
- Myoglobin is first enzyme to increase in cases of rhabdomyolysis, but it returns to normal levels within up to 24 hours after the onset of symptoms, because it is rapidly cleared by the kidneys. Serum CK levels remain elevated after serum and urine test results for myoglobin have become negative. CK levels normally peak (1000 U/L) around 3 days after the onset of symptoms, and remain elevated for several days. [3]
The comparison table for diagnostic studies of choice for [disease name]
Sensitivity | Specificity | |
---|---|---|
Creatine Kinase | 100% | 100% |
Myoglobin | 50% | style="background: #DCDCDC; padding: 5px; text-align: center;" 50% |
✔= The best test based on the feature
Diagnostic results
The following result of creatine kinase(CK) is confirmatory of myoglobinuria, caused my rhabdomyolysis:
- CK 1000 U/L
Sequence of Diagnostic Studies
The creatine kinase levels should be performed when:
- The patient presented with symptoms/signs of myalgia, muscle weakness, and dark urine as the first step of diagnosis.
- A positive creatine kinase level is detected in the patient, to confirm the diagnosis.
Diagnostic Criteria
- There are no established criteria for the diagnosis of [disease name].
References
- ↑ Khan FY (2009). "Rhabdomyolysis: a review of the literature". Neth J Med. 67 (9): 272–83. PMID 19841484.
- ↑ Chatzizisis YS, Misirli G, Hatzitolios AI, Giannoglou GD (2008). "The syndrome of rhabdomyolysis: complications and treatment". Eur J Intern Med. 19 (8): 568–74. doi:10.1016/j.ejim.2007.06.037. PMID 19046720.
- ↑ Lee G (2014). "Exercise-induced rhabdomyolysis". R I Med J (2013). 97 (11): 22–4. PMID 25365815.