Rhabdomyolysis laboratory findings

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

Laboratory Findings

• Urinalysis

  • Blood (+)
  • No red blood cells on microscopy. This situation is either hemoglobin in the urine or myoglobin. The serum will be pink with hemoglobinuria.

• Serum Markers

  • Elevated serum creatinine kinase

    • CK elevation: Generally accepted >5 times normal. Corresponds to about 200g of muscle.
    • Begins to rise 2-12 hrs after onset. Peaks 1-3 days in. Declines 3-5 days after the process stops.

  • Myoglobin

    • Myoglobin: Starts earlier than CK but clears faster, so serum and urine myoglobin useful early in course of the disease. Myoglobin is eventually urinated and/or converted to bilirubin.
    • All myoglobinuria is caused by rhabdomyolysis, but not all rhabdomyolysis causes myoglobinuria. Urine changes color when >1mg/ml.

  • LDH (lactic dehydrogenase)