The disintegration of striated muscles is an extremely rare syndrome, which may be caused by drug use, poisoning toxins (eg poisoning of some snakes), intense physical exercise, mechanical damage (eg crushing) and / or thermal, drug overdose, alcohol poisoning, heroin, cocaine, amphetamine, LSD, carbon monoxide, taking some drugs (statins, especially when suxamethonium, fibrates, cyclosporin, theophylline) are used during the induction of anesthesia.

In one case, a 32-year-old addict suffered from rhabdomyolysis, who had been taking heroin for several years. He experienced oliguria, urine drastically changed color (darkened), painful swelling of the lower limbs. Azotemia, electrolyte disturbances (hyperkalemia and hyponatraemia), proteinuria and hematuria (blood in the urine) occurred. He had elevated creatine kinase and LDH. He was diagnosed with muscle breakdown and acute kidney damage. In heroin addicts, the reason is muscle hypoxia, the immediate toxic effect of heroin on the muscles, immune response and vasospasm. 


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A marker of rhabdomyolysis is the level of CPK, or enzyme (creatine kinase CK or CPK) occurring mainly in muscles, heart and brain. An elevated CPK level indicates muscle damage. Normal value is 55-170 j / L for men and 30-135 j / L for women. 4 In the 33th issue of the Crossfit Journal the history of the wrestler, ranger and SWAT member, Brian, who after performing crossfit training (swings in a series of 50 reps) suffered a breakdown of skeletal muscle, which ended with a stay in hospital, catastrophic pain and the need to administer 16 mg of morphine every two hours! At the time of admission to the hospital with Brian, CPK amounted to 22,000, and within two days it increased to 98,000! Brian’s story was fine. He returned to the exercises. 

Meanwhile, the literature describes an extreme case of rhabdomyolysis after an ordinary one-hour session on a stationary bike. As we know in the stage of preparations for the competition, some bodybuilders use aerobies up to 8-10 x per week for 45-60 minutes. Unnecessary comment. The man after an hour’s cycling session had worse results than after the CK ultramaraton it was over 310,000 j / L! 

Finally, the Journal of Emergency Medicine 2 recently described the first case of clenbuterol-induced muscle breakdown (no longer used in human beta mimetic agents, because it was replaced by other, safer means). The man had a changed urine color, and the creatine kinase was 122,933 units / L (norm exceeded 723 times!). In man, no kidney damage was found, which often occurs together with rhabdomyolysis (myoglobin effect). 6 Clenbuterol has long been associated with heart problems. The most common side effects of its use are tachycardia, alimentary disorders (vomiting) and cramps. As it turns out, in extremely rare cases, it can even cause muscle breakdown! 


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