Any form of muscle damage of sufficient severity can cause rhabdomyolysis. Multiple causes can be present simultaneously in one person. Some have an underlying muscle condition, usually hereditary in nature, that makes them more prone to rhabdomyolysis. + Common and important causes Type Causes Exercise related Extreme physical exercise (particularly when poorly hydrated), delirium tremens (alcohol withdrawal), tetanus, prolonged seizures or<unk> s epilepticus Crush Crush syndrome, blast injury, car accident, physical torture or abuse, or confinement in a fixed position such as after a stroke, due to alcohol intoxication or in prolonged surgery Blood supply Arterial thrombosis (blood clots forming locally) or embolism (clots or other debris from elsewhere in the body), clamping of an artery during surgery Metabolism<unk> <unk><unk> , hyper- and hyponatremia (elevated or reduced blood sodium levels), hypokalemia (low potassium levels), hypocalcemia (low calcium levels), hypophosphatemia (low phosphate levels), ketoacidosis (e.g., in diabetic ketoacidosis) or hypothyroidism (abnormally low thyroid function) Body temperature Hyperthermia (high body temperature) and heat illness, hypothermia (very low body temperature) Drugs and toxins Many medications increase the risk of rhabdomyolysis. The most important ones are: *<unk> ns and fibrates, both used for elevated cholesterol, especially in combination; cerivastatin (Baycol) was withdrawn in 2001 after numerous reports of rhabdomyolysis. Other<unk> ns have a small risk of 0.44 cases per 10,000 person-years. Previous chronic kidney disease and hypothyroidism increase the risk of myopathy due to<unk> ns. It is also more common in the elderly, those who are severely disabled, and when<unk> ns are used in combination with particular other medicines, such as ciclosporin. *Antipsychotic medications may cause neuroleptic malignant syndrome, which can cause severe muscle rigidity with rhabdomyolysis and hyperpyrexia *Neuromuscular blocking agents used in anesthesia may result in malignant hyperthermia, also associated with rhabdomyolysis * Medications that cause serotonin syndrome, such as SSRIs * Medications that interfere with potassium levels, such as diuretics Poisons linked to rhabdomyolysis are heavy metals and venom from insects or snakes. Hemlock may cause rhabdomyolysis, either directly or after eating quail that have fed on it. Fungi such as Russula subnigricans and Tricholoma equestre are known to cause rhabdomyolysis. Haff disease is rhabdomyolysis after consuming fish; a toxic cause is suspected but has not been proven. Drugs of recreational use, including: alcohol, amphetamine, cocaine, heroin, ketamine and MDMA (ecstasy) Infection Coxsackie virus, influenza A virus and influenza B virus, Epstein-Barr virus, primary HIV infection, Plasmodium falciparum (malaria), herpes viruses, Legionella pneumophila and salmonella Inflammation Autoimmune muscle damage: polymyositis, dermatomyositis Genetic predisposition Recurrent rhabdomyolysis may result from intrinsic muscle enzyme deficiencies, which are usually inherited and often appear during childhood. Many structural muscle diseases feature episodes of rhabdomyolysis that are triggered by exercise, general anesthesia or any of the other causes of rhabdomyolysis listed above. Inherited muscle disorders and infections together cause the majority of rhabdomyolysis in children. The following hereditary disorders of the muscle energy supply may cause recurrent and usually exertional rhabdomyolysis: * Glycolysis and glycogenolysis defects: McArdle's disease, phosphofructokinase deficiency, glycogen storage diseases VIII, IX, X and XI * Lipid metabolism defects: carnitine palmitoyltransferase I and II deficiency, deficiency of subtypes of acyl CoA dehydrogenase (LCAD, SCAD, MCAD, VLCAD, 3-hydroxyacyl-coenzyme A dehydrogenase deficiency), thiolase deficiency * Mitochondrial myopathies: deficiency of succinate dehydrogenase, cytochrome c oxidase and coenzyme Q10 * Others: glucose-6-phosphate dehydrogenase deficiency, myoadenylate deaminase deficiency and muscular dystrophies
complications of Hyperosmolar hyperglycemic state
complications of Diabetic ketoacidosis
complications of Noonan syndrome
medical cause of Hypoglycemia
complications of Diabetes insipidus
complications of Graves' disease
complications of Acromegaly
complications of Hashimoto's thyroiditis