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A source of myoglobinuria…

T. David Bourne, MD renal pathologist and neuropathologist at arkana laboratories
By David Bourne, MD

Sep 26, 2018


The image shows a frozen cross section of skeletal muscle from a patient with rhabdomyolysis, which included the full clinical syndrome of muscle pain, weakness, dark urine, and markedly elevated serum creatine kinase.  The image shows three necrotic fibers engulfed by macrophages (arrow). 

So what causes such muscle injury?  The broad differential diagnosis includes trauma, drugs (e.g. statins, alcohol, heroin, cocaine), toxins (e.g. metabolic poisons, animal venom), inflammatory myopathy, immune-mediated necrotizing myopathy (e.g. anti-HMG CoA reductase associated myopathy), infection (e.g. EBV, influenza), paraneoplastic myopathy, and metabolic myopathy (e.g. disorders of glycolysis, lipid metabolism, mitochondria).


Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.