myoglobinuria

ミオグロビン尿 　

WordNet

1. the presence of myoglobin in the urine
2. not usual or common or ordinary; "a scene of unusual beauty"; "a man of unusual ability"; "cruel and unusual punishment"; "an unusual meteorite"
3. not commonly encountered; "two-career families are no longer unusual"

PrepTutorEJDIC

1. 『普通でない』,異常な;まれな,珍しい(rare) / 独特の,特有の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/14 00:22:34」(JST)

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[Wiki en表示]

Myoglobinuria
Urine from a person with rhabdomyolysis showing the characteristic brown discoloration as a result of myoglobinuria
Classification and external resources
ICD-10	R82.1
ICD-9-CM	791.3
DiseasesDB	23059
eMedicine	ped/1535
Patient UK	Myoglobinuria
MeSH	D009212

Myoglobinuria is the presence of myoglobin in the urine, usually associated with rhabdomyolysis or muscle destruction. Myoglobin is present in muscle cells as a reserve of oxygen.

Signs and symptoms

Signs and symptoms of myoglobinuria are usually nonspecific and needs some clinical prudence.Therefore among the possible signs and symptoms to look for would be:

• Swollen and painful muscles
• Fever, nausea
• Delirium (elderly individuals)
• Myalgia
• Dark urine
• Calcium ions (decrease)

Causes

Model of helical domains in myoglobin.

Trauma, vascular problems, malignant hyperthermia, certain drugs and other situations can destroy or damage the muscle, releasing myoglobin to the circulation and thus to the kidneys. Under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of renal problems, it can occlude the renal filtration system leading to acute tubular necrosis and acute renal insufficiency.

Other causes of myoglobinuria include:

• McArdle's disease
• Phosphofructokinase deficiency
• Carnitine palmitoyltransferase II deficiency
• malignant hyperthermia
• Polymyositis
• Lactate Dehydrogenase Deficiency

Pathophysiology

Myoglobinuria pathophysiology consist of a series of metabolic actions in which damage to muscle cells affect calcium mechanisms, thereby increasing free ionized calcium (cytoplasm). This in turn affects several enzymes that are calcium dependent, thereby compromising the cell membrane, which in turn causes the release of myoglobin.

Diagnosis

After centrifuging, the urine of myoglobinuria is clear, where the serum of hemoglobinuria after centrifuge is pink to red.

Treatment

Hospitalization and IV hydration should be the first step in any patient suspected of having myoglobinuria or rhabdomyolysis. The goal is to induce a brisk diuresis to prevent myoglobin precipitation and deposition, which can cause acute kidney injury. Mannitol can be added to assist with diuresis. Adding sodium bicarbonate to the IV fluids will cause alkalinzation of the urine, believed to reduce the breakdown of myoglobin into its nephrotoxic metabolites, thus preventing renal damage. Often, IV normal saline is all that is needed to induce diuresis and alkalinize the urine.

Epidemiology

References

Further reading

• Pedley, edited by Lewis P. Rowland, Timothy A. (2010). Merritt's neurology. (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. p. 885. ISBN 978-0781791861. Retrieved 10 September 2015. 
• Nyhan, edited by Georg F. Hoffmann, Johannes Zschocke, William L. (2010). Inherited metabolic diseases : a clinical approach. Heidelberg: Springer. p. 165. ISBN 978-3-540-74722-2. Retrieved 10 September 2015. 

External links

• Overview on the Neuromuscular disease center website.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 横紋筋融解症の臨床症状および診断 clinical manifestations and diagnosis of rhabdomyolysis
• 2. 代謝性ミオパチーへのアプローチ approach to the metabolic myopathies
• 3. 腎疾患の診断における尿検査 urinalysis in the diagnosis of kidney disease
• 4. ヘム色素誘発急性腎障害（急性腎不全）の臨床的特徴および診断 clinical features and diagnosis of heme pigment induced acute kidney injury acute renal failure
• 5. 横紋筋融解症の原因 causes of rhabdomyolysis

English Journal

• Case Report: Red Urine After Day Care Strabismus Surgery.

• Caroline P1, Marie-Cécile N, Demet Y, Francis V.
• A & A case reports.A A Case Rep.2017 Feb 15;8(4):75-77. doi: 10.1213/XAA.0000000000000430.
• PMID 28045721

• Renal Involvement in Idiopathic Inflammatory Myopathies.

• Cucchiari D1, Angelini C2.
• Clinical reviews in allergy & immunology.Clin Rev Allergy Immunol.2017 Feb;52(1):99-107. doi: 10.1007/s12016-015-8524-5.
• PMID 26590948

• Ritodrine-induced rhabdomyolysis, infantile myotonic dystrophy, and maternal myotonic dystrophy unveiled.

• Ogoyama M1, Takahashi H1, Kobayashi Y1, Usui R1, Matsubara S1.
• The journal of obstetrics and gynaecology research.J Obstet Gynaecol Res.2017 Feb;43(2):403-407. doi: 10.1111/jog.13211. Epub 2016 Dec 17.
• PMID 27987333

Japanese Journal

• A Heterozygous Missense Mutation in Adolescent-Onset Very Long-Chain Acyl-CoA Dehydrogenase Deficiency with Exercise-Induced Rhabdomyolysis

• , , , , , ,
• The Tohoku Journal of Experimental Medicine 235(4), 305-310, 2015
• … Rhabdomyolysis was diagnosed based on the marked elevation of serum creatine kinase and myoglobinuria. …
• NAID 130005061503

• 手術1週間後に術後悪性高熱症を疑い,ダントロレンが奏効した1症例

• 伊藤 一志,西部 伸一,磨田 裕 [他]
• 麻酔 63(10), 1153-1155, 2014-10
• NAID 40020224594

• 新型インフルエンザウイルス感染による横紋筋融解症によって急性腎傷害を生じた高齢者の1例

• 松吉 健夫,岡田 保誠,稲川 博司,小島 直樹,山口 和将,佐々木 庸郎
• 日本救急医学会雑誌 24(9), 781-786, 2013
• 新型インフルエンザウイルス感染による横紋筋融解症によって，急性腎傷害を生じた高齢者の1例を経験したので報告する。症例は，統合失調症により精神科病院に長期入院中の75歳の男性である。前医で発熱を契機にインフルエンザウイルス感染と診断され，翌日の検査にて横紋筋融解症，急性腎傷害を認めたため当院救命救急センターに搬送された。ICUに入室し治療を開始したが，大量輸液，利尿促進に反応せず，第2病日に血液透析 …
• NAID 130004840973

Related Links

• Myoglobinuria Symptoms, Diagnosis, Treatments and Causes ...

Myoglobinuria information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. ... Myoglobinuria: Introduction Myoglobinuria: Myoglobin (muscle protein) in the ...

• myoglobinuria - definition of myoglobinuria by Medical dictionary

my·o·glo·bi·nu·ri·a (mī′ə-glō′bə-no or′ē-ə) n. Excretion of myoglobin in the urine. Myoglobinuria Reddish urine caused by excretion of myoglobin, a breakdown product of muscle. Mentioned in: Alcohol-Related Neurologic Disease

Related Pictures

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★リンクテーブル★

リンク元	「ミオグロビン尿」「unusual」「ミオグロビン尿症」
拡張検索	「acute recurrent myoglobinuria」「familial myoglobinuria」「idiopathic myoglobinuria」「paroxysmal myoglobinuria」

「ミオグロビン尿」

　　[★]

英

myoglobinuria

関

ミオグロビン、ミオグロビン尿症、赤いおむつ症候群、ミオグロビン塩析法

定義

• ミオグロビンが尿中に排泄された状態

ミオグロビン尿とヘモグロビン尿

	ヘモグロビン尿	ミオグロビン尿
肉眼的観察	赤色透明	赤色透明
鏡検による赤血球	陰性	陰性
尿潜血反応	陽性	陽性
血漿の色調	赤色	黄色

「unusual」

　　[★]

• adj.

• 普通でない、異常な、並はずれた、聞き慣れない、珍しい、変わった。

it is not unusual for CK levels to remain elevated in the absence of myoglobinuria.(よくある or 珍しいことではない)

関

aberrant, aberrantly, aberration, abnormal, abnormality, abnormally, anomalous, anomalously, anomaly, defect, deviant, extraordinarily, extraordinary, rare, uncommon, unique, unusually

　 　 　

「ミオグロビン尿症」

　　[★]

英

myoglobinuria

関

ミオグロビン尿

「acute recurrent myoglobinuria」

　　[★] 急性再発性ミオグロブリン尿症

「familial myoglobinuria」

　　[★] 家族性ミオグロビン尿症

「idiopathic myoglobinuria」

　　[★] 特発性ミオグロビン尿症

「paroxysmal myoglobinuria」

　　[★] 発作性ミオグロビン尿症