Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis

Andréia Carneiro, Diego Viana-Gomes, Janaina Macedo-da-Silva, Giscard Humberto Oliveira Lima, Simone Mitri, Sergio Rabello Alves, Alexander Kolliari-Turner, Edmar Zanoteli, Francisco Radler de Aquino Neto, Giuseppe Palmisano, João Bosco Pesquero, Josino Costa Moreira, Marcos Dias Pereira

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Exertional rhabdomyolysis may occur when an individual is subjected to strenuous physical exercise. It is occasionally associated with myoglobinuria (i.e. “cola-colored” urine) alongside muscle pain and weakness. The pathophysiology of exertional rhabdomyolysis involves striated muscle damage and the release of cellular components into extracellular fluid and bloodstream. This can cause acute renal failure, electrolyte abnormalities, arrhythmias and potentially death. Exertional rhabdomyolysis is observed in high-performance athletes who are subjected to intense, repetitive and/or prolonged exercise but is also observed in untrained individuals and highly trained or elite groups of military personnel. Several risk factors have been reported to increase the likelihood of the condition in athletes, including: viral infection, drug and alcohol abuse, exercise in intensely hot and humid environments, genetic polymorphisms (e.g. sickle cell trait and McArdle disease) and epigenetic modifications. This article reviews several of these risk factors and proposes screening protocols to identify individual susceptibility to exertional rhabdomyolysis as well as the relevance of proteomics for the evaluation of potential biomarkers of muscle damage.
    Original languageEnglish
    Pages (from-to)583-595
    Number of pages13
    JournalNeuromuscular Disorders
    Volume31
    Issue number7
    DOIs
    Publication statusPublished - 5 May 2021

    Bibliographical note

    Funding Information: The authors would like to thank the Comando do Material do Corpo de Fuzileiros Navais, Marinha do Brasil, Centro de Instru??o Almirante Sylvio de Camargo, Marinha do Brasil; Centro de Tecnologia do Corpo dos Fuzileiros Navais, Marinha do Brasil. We also thank the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES), Conselho Nacional de Pesquisas e Desenvolvimento Tecnol?gico (CNPq), Funda??o Carlos Chagas de Amparo ? Pesquisa do Rio de Janeiro (FAPERJ) and Funda??o de Amparo ? Pesquisa do Estado de S?o Paulo (FAPESP - 2018/18257-1, 2018/15549-1, 2020/04923-0 and 2014/27298-8) who provided financial support for this study. Funding Information: The authors would like to thank the Comando do Material do Corpo de Fuzileiros Navais, Marinha do Brasil, Centro de Instrução Almirante Sylvio de Camargo, Marinha do Brasil; Centro de Tecnologia do Corpo dos Fuzileiros Navais, Marinha do Brasil. We also thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Pesquisas e Desenvolvimento Tecnológico (CNPq), Fundação Carlos Chagas de Amparo à Pesquisa do Rio de Janeiro (FAPERJ) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP - 2018/18257-1, 2018/15549-1, 2020/04923-0 and 2014/27298-8) who provided financial support for this study.

    Keywords

    • Acute renal failure
    • Epigenetics
    • Exertional rhabdomyolysis
    • Genetic polymorphisms
    • Military personnel
    • Proteomics
    • Risk factors

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