Table 1.

Etiology of rhabdomyolysis

  • Physical causes

    • trauma and compression

      • traffic or working accidents

      • disasters

      • torture

      • abuse

      • long-term confinement to the same position

    • occlusion or hypoperfusion of the muscular vessels

      • thrombosis

      • embolism

      • vessel clamping

      • shock

    • strainful exercise of muscles

      • exercise

      • epilepsy

      • psychiatric agitation

      • delirium tremens

      • tetanus

      • amphetamine overdose

      • ecstasy

      • status asthmaticus

    • electrical current

      • high-voltage electrical injury

      • lightning

      • cardioversion

    • hyperthermia

      • exercise

      • high ambient temperatures

      • sepsis

      • neuroleptic malignant syndrome

      • malignant hyperthermia

  • Nonphysical causes

    • metabolic myopathies

      • McArdle disease

      • mitochondrial respiratory chain enzyme deficiencies

      • carnitine palmitoyl transferase deficiency

      • myoadenylate deaminase deficiency

      • phosphofructokinase deficiency

    • drugs and toxins

      • regular and illegal drugs (see Table 2)

      • toxins

        • snake and insect venoms

        • buffalo fish (United States), burbot (Northern Europe)—Haff disease

    • infections

      • local infection with muscular invasion (pyomyositis)

      • metastatic infection (sepsis)

      • systemic effects

        • toxic shock syndrome

        • Legionella

        • tularemia

        • Salmonella

        • falciparum malaria

        • influenza

        • HIV

        • herpes viruses

        • coxsakievirus

    • electrolyte abnormalities

      • hypokalemia

      • hypocalcemia

      • hypophosphatemia

      • hyponatremia

      • hypernatremia

      • hyperosmotic conditions

    • endocrine disorders

      • hypothyroidism

      • diabetic coma, related to electrolyte disturbances

    • polymyositis/dermatomyositis