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Rhabdomyolyse und Myoglobinurie

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Zusammenfassung

Bei der Rhabdomyolyse kommt es zu einer Freisetzung von Muskelzellbestandteilen in den Blutkreislauf nach direkter Schädigung des Sarkolemms bzw. Ausfall der Energieversorgung innerhalb der Muskelzelle mit Anstieg potenziell toxischer Muskelzellbestandteile, Kreatinkinase (CK) und Myoglobin im Serum. Das häufige Auftreten einer assoziierten Myoglobinurie führte dazu, dass die Begriffe Rhabdomyolyse und Myoglobinurie oft synonym verwandt wurden. Komplikationen der Rhabdomyolyse sind akutes Nierenversagen, Hyperkaliämie mit Herzstillstand, disseminierte intravasale Gerinnungsstörung oder lokal ein akutes Kompartmentsyndrom. Das Krankheitsbild ist hinsichtlich der Ätiologie sehr heterogen und kann durch eine Vielzahl unterschiedlicher Erkrankungen, die zu einer Schädigung der Muskelzellmembranen, Ionenkanäle oder der muskulären Einergieversorgung führen, hervorgerufen werden.

Summary

Rhabdomyolysis is a disorder characterized by acute damage of the sarcolemma of the skeletal muscle leading to release of potentially toxic muscle cell components into the circulation, most notably creatine phosphokinase (CK) and myoglobin, and is frequently accompanied by myoglobinuria. Therefore, the term myoglobinuria is often used interchangeably with the term rhabdomyolysis. This disorder may result in potential life-threatening complications such as acute myoglobinuric renal failure, hyperkalemia and cardiac arrest, disseminated intravascular coagulation, and compartment syndrome. The condition is etiologically heterogeneous and may result from a large variety of diseases affecting muscle membranes, membrane ion channels, and muscle energy supply including acquired causes (e.g., exertion, crush injury and trauma, alcoholism, drugs, and toxins) and hereditary causes (e.g., disorders of carbohydrate metabolism, disorders of lipid metabolism, or diseases of the muscle associated with malignant hyperthermia). In many patients with idiopathic recurrent rhabdomyolysis, specific inherited metabolic defects have not been recognized up to now.

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  1. Neurologische Klinik, Marienhospital Stuttgart

    A. Lindner

  2. Neurologische Klinik und Poliklinik, Martin-Luther-Universität Halle-Wittenberg

    S. Zierz

  3. Neurologische Klinik, Marienhospital Stuttgart, Böheimstraße 37, 70199 , Stuttgart

    A. Lindner

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Lindner, A., Zierz, S. Rhabdomyolyse und Myoglobinurie. Nervenarzt 74, 505–515 (2003). https://doi.org/10.1007/s00115-003-1518-1

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