Abstract
Exertional rhabdomyolysis, a syndrome characterized by skeletal muscle degeneration and muscle enzyme leakage, has been shown to occur in normal, healthy individuals following strenuous exercise. In severe cases, this syndrome can result in renal failure and sudden death. Although anyone who performs strenuous exercise may be at risk for developing exertional rhabdomyolysis, some individuals may be more susceptible than others. A number of case reports of exertional rhabdomyolysis involve persons with sickle-cell trait, leading to the theory that these individuals might be at greater risk for developing the syndrome than those without this trait. This article discusses the etiology of exertional rhabdomyolysis, the associated risk factors for persons with sickle-cell trait, and the recommended preventive measures. Additionally, several case studies of exertional rhabdomyolysis are reviewed.
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Selected References
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- Demos M. A., Gitin E. L. Acute exertional rhabdomyolysis. Arch Intern Med. 1974 Feb;133(2):233–239. [PubMed] [Google Scholar]
- Diggs L. W., Flowers E. High school athletes with the sickle cell trait (Hb A/S). J Natl Med Assoc. 1976 Nov;68(6):492-3, 479. [PMC free article] [PubMed] [Google Scholar]
- Hansen K. N., Bjerre-Knudsen J., Brodthagen U., Jordal R., Paulev P. E. Muscle cell leakage due to long distance training. Eur J Appl Physiol Occup Physiol. 1982;48(2):177–188. doi: 10.1007/BF00422979. [DOI] [PubMed] [Google Scholar]
- Helzlsouer K. J., Hayden F. G., Rogol A. D. Severe metabolic complications in a cross-country runner with sickle cell trait. JAMA. 1983 Feb 11;249(6):777–779. [PubMed] [Google Scholar]
- Hynd R. F., Bharadwaja K., Mitas J. A., Lord J. T. Rhabdomyolysis, acute renal failure, and disseminated intravascular coagulation in a man with sickle cell trait. South Med J. 1985 Jul;78(7):890–891. doi: 10.1097/00007611-198507000-00033. [DOI] [PubMed] [Google Scholar]
- Iiboshi A., Tokuda S., Nishimura T., Otsuji S. Biphasic changes of blood myoglobin level in weight training. J Sports Med Phys Fitness. 1982 Sep;22(3):284–294. [PubMed] [Google Scholar]
- Kark J. A., Posey D. M., Schumacher H. R., Ruehle C. J. Sickle-cell trait as a risk factor for sudden death in physical training. N Engl J Med. 1987 Sep 24;317(13):781–787. doi: 10.1056/NEJM198709243171301. [DOI] [PubMed] [Google Scholar]
- Koppes G. M., Daly J. J., Coltman C. A., Jr, Butkus D. E. Exertion-induced rhabdomyolysis with acute renal failure and disseminated intravascular coagulation in sickle cell trait. Am J Med. 1977 Aug;63(2):313–317. doi: 10.1016/0002-9343(77)90247-9. [DOI] [PubMed] [Google Scholar]
- Milne C. J. Rhabdomyolysis, myoglobinuria and exercise. Sports Med. 1988 Aug;6(2):93–106. doi: 10.2165/00007256-198806020-00004. [DOI] [PubMed] [Google Scholar]
- Murphy J. R. Sickle cell hemoglobin (Hb AS) in black football players. JAMA. 1973 Aug 20;225(8):981–982. [PubMed] [Google Scholar]
- Ramírez A., Hartley L. H., Rhodes D., Abelmann W. H. Morphological features of red blood cells in subjects with sickle cell trait: changes during exercise. Arch Intern Med. 1976 Sep;136(9):1064–1066. doi: 10.1001/archinte.1976.03630090086021. [DOI] [PubMed] [Google Scholar]
- Robinson J. R., Stone W. J., Asendorf A. C. Exercise capacity of black sickle cell trait males. Med Sci Sports. 1976 Winter;8(4):244–245. [PubMed] [Google Scholar]
- Rosenthal M. A., Parker D. J. Collapse of a young athlete. Ann Emerg Med. 1992 Dec;21(12):1493–1498. doi: 10.1016/s0196-0644(05)80068-x. [DOI] [PubMed] [Google Scholar]
- Roth E., Jr The sickle cell gene in evolution: a solitary wanderer or a nomad in a caravan of interacting genes. JAMA. 1985 Apr 19;253(15):2259–2260. [PubMed] [Google Scholar]
- Roti S., Iori E., Guiducci U., Emanuele R., Robuschi G., Bandini P., Gnudi A., Roti E. Serum concentrations of myoglobin, creatine phosphokinase and lactic dehydrogenase after exercise in trained and untrained athletes. J Sports Med Phys Fitness. 1981 Jun;21(2):113–118. [PubMed] [Google Scholar]
- Roxin L. E., Hedin G., Venge P. Muscle cell leakage of myoglobin after long-term exercise and relation to the individual performances. Int J Sports Med. 1986 Oct;7(5):259–263. doi: 10.1055/s-2008-1025771. [DOI] [PubMed] [Google Scholar]
- Sateriale M., Hart P. Unexpected death in a black military recruit with sickle cell trait: case report. Mil Med. 1985 Nov;150(11):602–605. [PubMed] [Google Scholar]
- Schiff H. B., MacSearraigh E. T., Kallmeyer J. C. Myoglobinuria, rhabdomyolysis and marathon running. Q J Med. 1978 Oct;47(188):463–472. [PubMed] [Google Scholar]
- Schrier R. W., Hano J., Keller H. I., Finkel R. M., Gilliland P. F., Cirksena W. J., Teschan P. E. Renal, metabolic, and circulatory responses to heat and exercise. Studies in military recruits during summer training, with implications for acute renal failure. Ann Intern Med. 1970 Aug;73(2):213–223. doi: 10.7326/0003-4819-73-2-213. [DOI] [PubMed] [Google Scholar]
- Sherry P. Sickle cell trait and rhabdomyolysis: case report and review of the literature. Mil Med. 1990 Feb;155(2):59–61. [PubMed] [Google Scholar]
- Soni S. N., McDonald E., Marino C. Rhabdomyolysis after exercise. Postgrad Med. 1993 Nov 1;94(6):128–132. doi: 10.1080/00325481.1993.11945748. [DOI] [PubMed] [Google Scholar]
- Zimmerman J., Granatir R., Mummert K., Cioffi R. Sickle crisis precipitated by exercise rhabdomyolysis in a patient with sickle cell trait: case report. Mil Med. 1974 Apr;139(4):313–315. [PubMed] [Google Scholar]
