Myoglobinuria (from other Greek. Μυών - muscle , Latin globulinum - globulin and other Greek. Οὖρον - urine ) - a syndrome expressed in the presence of myoglobin pigment in the urine , which is a chromoprotein ; observed with pathological breakdown of muscle protein . In this case, the urine acquires a red-brown color.
| Myoglobinuria | |
|---|---|
 Spiral domain model in myoglobin . | |
| ICD-10 | R 82.1 |
| ICD-10-KM | |
| ICD-9 | 791.3 |
| Omim | , , , , and |
| Diseasesdb | 23059 |
| eMedicine | ped / 1535 |
| Mesh | D009212 |
Complicates rhabdomyolysis (traumatic, ischemic, toxic, genetic). Massive myoglobinuria, damaging the renal convoluted tubules , can lead to acute renal failure .
Myoglobinuria is manifested by the release of urine of red or dark brown color, dysuria , sometimes back pain. Differential diagnosis of myoglobinuria from macrohematuria is based on microscopy of urine sediment. Often there are difficulties in distinguishing between myoglobinuria and hemoglobinuria . With myoglobinuria, in contrast to hemoglobinuria, red-brown staining of urine remains after the addition of ammonium sulfate . The most accurate diagnostic method is the immunoelectrophoretic determination of myoglobin.
Content
Causes of occurrence
It is observed with pathological breakdown of muscle protein, which is facilitated by the action of certain drugs and other factors.
Myoglobinuria develops with prolonged compression syndrome (crash syndrome) during natural and military disasters, destruction of buildings, etc., when myoglobin from crushed and crushed muscles enters the bloodstream and is partially excreted by the kidneys . The thickening of blood that occurs with the loss of intravascular fluid contributes to the deposition of myoglobin in the renal tubules . Their blockade leads to the development of renal failure , which requires intensive treatment in oligoanuria using efferent methods ( hemodialysis ).
Myoglobinuria should not be confused with hematuria . In the first case, clumps of myoglobin are found in the urine, but it is transparent, in the second, the urine contains red blood cells and it is cloudy.
Varieties
- Myoglobinuria marching - see. Hemoglobinuria marching
- Myoglobinuria paralytic (myoglobinuria paralytica; synonym: Meyer-Betz disease , Meyer-Betts syndrome ) is a combination of myopathy syndromes and reversible myoglobinuria in which, after an attack of muscle weakness and muscle soreness (mainly lower extremities), myoglobinuria appears, accompanied by the presence of albumin in the urine, white blood cells , red blood cells ; attacks occur spontaneously or after prolonged muscle tension.
- Myoglobinuria paroxysmal (myoglobinuria paroxysmalis) is a familial disease of unclear etiology , manifested by periodic myoglobinuria and attacks of muscle pain.
- Myoglobinuria paroxysmally toxic alimentary (myoglobinuria paroxysmalis toxica alimentaria) - see. Yuksovsky-Sartlansky disease
- Traumatic myoglobinuria (myoglobinuria traumatica) - myoglobinuria that occurs some time after an extensive injury with a crush and necrobiosis of the muscles.
Other causes of myoglobinuria:
- McArdle's disease
- Lack of phosphofructokinase [1]
- Malignant Neuroleptic Syndrome (CNS)
Myoglobinuria in Veterinary Medicine
This is an acute disease of horses with a deep metabolic disorder, accompanied by regidity, dystrophic changes in skeletal muscles and the appearance in the blood and urine of myoglobin and its decomposition products. The disease is characterized by a rapid transition from a latent to a clinically pronounced course with the development of paresis and paralysis. A similar disease can occur in working oxen and other animals more often in the winter-spring period [2] .
See also
- Rhabdomyolysis
Links
- Site of the Center for Neuromuscular Diseases (English) (Retrieved April 26, 2009)
Notes
- ↑ Toscano A., Musumeci O. Tarui disease and distal glycogenoses: clinical and genetic update (neopr.) // Acta Myol. - 2007. - October ( t. 26 , No. 2 ). - S. 105-107 . - PMID 18421897 .
- ↑ A.V. Zharov, V.P. Shishkov et al. Pathological anatomy of farm animals. - M .: Kolos, 1995 .-- 543 p.