Incidence of acute exertional rhabdomyolysis. Serum myoglobin and enzyme levels as indicators of muscle injury.

This study was conducted to determine, on a prospective basis, the incidence of acute exertional rhabdomyolysis (AER) among recruits at the Marine Corps Recruit Depot, San Diego, Calif. Blood samples were taken from each of 337 volunteer recruits on each of their first six days of regularly scheduled training. Serum myoglobin, serum creatine phosphokinase, lactic dehydrogenase, and serum glutamic oxaloacetic transaminase values were used as indicators of muscle injury. Substantial elevations of serum enzyme activity were observed throughout the study population. Of the study population, 39.2% had serum myoglobin levels that ranged from 0.37 mug/ml to 21.9 mug/ml during the study interval. Six subjects had serum myoglobin levels consistent with those reported in clinical cases of AER. It is concluded that, in a recruit population, large numbers of men may have myoglobinemia but not be seen initially as clinical cases.

[1]  E. Hultman,et al.  Muscle glycogen synthesis in relation to diet studied in normal subjects. , 2009, Acta medica Scandinavica.

[2]  J. Madsen.  Extrapancreatic and intrapancreatic action of antidiabetic sulphonylureas. A review. , 2009, Acta medica Scandinavica. Supplementum.

[3]  L. Homer,et al.  Serum myoglobin levels predicted from serum enzyme values. , 1975, The New England journal of medicine.

[4]  S. Scheidt,et al.  Myoglobinemia following acute myocardial infarction. , 1975, The American journal of medicine.

[5]  L. Kagen,et al.  Exercise myoglobinemia and acute exertional rhabdomyolysis. , 1974, Archives of internal medicine.

[6]  J. Olerud,et al.  Maximal oxygen uptake based on lean body mass: a meaningful measure of physical fitness? , 1974, Journal of applied physiology.

[7]  D. E. Uddin,et al.  Screening of military recruits for hemoglobin variants. , 1974, JAMA.

[8]  D. E. Uddin,et al.  Glucose-6-phosphate dehydrogenase deficiency in military recruits. , 1974, JAMA.

[9]  M. A. Demos,et al.  Acute exertional rhabdomyolysis. , 1974, Archives of internal medicine.

[10]  S. Dimauro,et al.  Muscle Carnitine Palmityltransferase Deficiency and Myoglobinuria , 1973, Science.

[11]  B. Saltin,et al.  Muscle lactate, ATP, and CP levels during exercise after physical training in man. , 1972, Journal of applied physiology.

[12]  A. Penn,et al.  Acute tubular necrosis caused by exercise-induced myoglobinuria. , 1972, Annals of internal medicine.

[13]  N. Carter,et al.  Rhabdomyolysis and myoglobinuria. Association with hypokalemia of renal tubular acidosis. , 1972, JAMA.

[14]  R. Hamburger,et al.  Pathophysiology of intense physical conditioning in a hot climate. I. Mechanisms of potassium depletion. , 1972, The Journal of clinical investigation.

[15]  J. B. Critz,et al.  Effect of training on plasma enzyme levels in man. , 1971, Journal of applied physiology.

[16]  R. Schrier,et al.  Renal, metabolic, and circulatory responses to heat and exercise. Studies in military recruits during summer training, with implications for acute renal failure. , 1970, Annals of internal medicine.

[17]  H. Haimovici.  Arterial embolism, myoglobinuria, and renal tubular necrosis. , 1970, Archives of surgery.

[18]  Jackson Rc.  Exercise-induced renal failure and muscle damage. , 1970 .

[19]  Mosher Wb.  Sickle-cell trait. , 1970, New England Journal of Medicine.

[20]  R. Binder,et al.  Sudden death in sickle-cell trait. , 1970, The New England journal of medicine.

[21]  E. Schmidt,et al.  Enzyme Modifications During Activity , 1969 .

[22]  F. Nuttall,et al.  Creatine kinase and glutamic oxalacetic transaminase activity in serum: kinetics of change with exercise and effect of physical conditioning. , 1968, The Journal of laboratory and clinical medicine.

[23]  R. Smith.  Exertional rhabdomyolysis in Naval Officer Candidates. , 1968, Archives of internal medicine.

[24]  E Hultman,et al.  Muscle glycogen during prolonged severe exercise. , 1967, Acta physiologica Scandinavica.

[25]  J. Knochel,et al.  Acute renal failure due to heat injury. An analysis of ten cases associated with a high incidence of myoglobinuria. , 1967, The American journal of medicine.

[26]  L. Kagen,et al.  Precipitin reactions of anti-human myoglobin serum with several human and animal muscle extracts. , 1967, Immunology.

[27]  J. Greenberg,et al.  Exertional rhabdomyolysis with myoglobinuria in a large group of military trainees , 1967, Neurology.

[28]  L. Kagen,et al.  Immunologic measurements of myoglobin in human adult and fetal skeletal muscle. , 1966, The American journal of physiology.

[29]  G. Perkoff,et al.  Reversible acute muscular syndrome in chronic alcoholism. , 1966, The New England journal of medicine.

[30]  E. Hultman,et al.  Muscle Glycogen Synthesis after Exercise : an Enhancing Factor localized to the Muscle Cells in Man , 1966, Nature.

[31]  M. Gerbrandt,et al.  Rare muscle disease. Acute idiopathic rhabdomyolysis with renal tubular necrosis. , 1966, The Journal of the Kansas Medical Society.

[32]  A. Tavill,et al.  IDIOPATHIC PAROXYSMAL MYOGLOBINURIA WITH ACUTE RENAL FAILURE AND HYPERCALCEMIA. , 1964, The New England journal of medicine.

[33]  E. L. Harley,et al.  EXERTIONAL IDIOPATHIC PAROXYSMAL MYOGLOBINURIA. EVIDENCE OF A DEFECT IN SKELETAL MUSCLE METABOLISM. , 1963, The American journal of medicine.

[34]  C. Pearson,et al.  Changes in serum enzyme levels after exercise in trained and untrained subjects. , 1962, Journal of applied physiology.

[35]  L. Levine,et al.  Quantitative micro-complement fixation and its use in the study of antigenic structure by specific antigen-antibody inhibition. , 1961, Journal of immunology.

[36]  Turell Dj.  Primary myoglobinuria and exercise-induced secondary myoglobinuria: a report of 7 cases seen at an army basic training center. , 1961 .

[37]  H. Denson.  Primary myoglobinuria (Meyer-Betz disease). , 1960, The American journal of medicine.

[38]  J. Howenstine.  Exertion-induced myoglobinuria and hemoglobinuria; simulation of acute glomerulonephritis. , 1960, Journal of the American Medical Association.

[39]  T. Spaet,et al.  Idiopathic Paroxysmal Myoglobinuria: Report of a Case with Studies on Serum Haptoglobin Levels , 1959 .

[40]  W. Stahl.  March hemoglobinuria; report of five cases in students at Ohio State University. , 1957, Journal of the American Medical Association.

[41]  K. Zierler.  Movement of aldolase from excised rat diaphragm. , 1956, The American journal of physiology.

[42]  B. McArdle.  MYOPATHY DUE TO A DEFECT IN MUSCLE GLYCOGEN BREAKDOWN , 1951, Clinical science.

[43]  L. Rowell,et al.  Human cardiovascular adjustments to exercise and thermal stress. , 1974, Physiological reviews.

[44]  K. Piehl.  Glycogen storage and depletion in human skeletal muscle fibres. , 1974, Acta physiologica Scandinavica. Supplementum.

[45]  V. J. Nessan,et al.  Hypernatremia with myoglobinuria. , 1973, The American journal of the medical sciences.

[46]  B. Saltin,et al.  ENERGY NEED, DELIVERY, AND UTILIZATION IN MUSCULAR EXERCISE , 1973 .

[47]  L. Kagen.  Myoglobin ; biochemical, physiological, and clinical aspects , 1973 .