Myoglobinuria

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Myoglobinuria
Myoglobin.png
Model of helical domains in myoglobin.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Myoglobinuria is the presence of myoglobin in the urine, usually associated with rhabdomyolysis or muscle destruction. Myoglobin is present in muscle cells as a reserve of oxygen.

Pathophysiology

Under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of renal problems, it can occlude the renal filtration system leading to acute tubular necrosis and acute renal insufficiency.

Causes

See also: Rhabdomyolysis causes

Common Causes

Causes by Organ System

Cardiovascular Myocardial infarction, Myocarditis
Chemical/Poisoning Haff disease, Snake bite , Venom
Dental No underlying causes
Dermatologic Dermatomyositis
Drug Side Effect Barbiturates, Carbenoxolone, Diamorphine, Fibrate, Malignant hyperpyrexia, Neuroleptic malignant syndrome, Statins, Trabectedin
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental Heat stroke
Gastroenterologic No underlying causes
Genetic Brody myopathy, Carnitine palmitoyltransferase 1 deficiency, Carnitine palmitoyltransferase 2 deficiency, Familial paroxysmal rhabdomyolysis, Glycogen storage disease type V, Myopathy with deficiency of succinate dehydrogenase and aconitase, Phosphoglycerate kinase deficiency, Phosphogylcerate mutase 2 deficiency, Very long-chain acyl-coenzyme A dehydrogenase deficiency
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic Brody myopathy, Compartment syndrome, Dermatomyositis, Polymyositis, Rhabdomyolysis
Neurologic Choreoathetosis, Seizures
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes]
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Hypokalaemia, Hypophosphataemia
Rheumatology/Immunology/Allergy Dermatomyositis, Polymyositis
Sexual No underlying causes
Trauma Burns, Crush syndrome, Electric shock, Trauma
Urologic No underlying causes
Miscellaneous Exercise, Meyer-betz disease

Causes in Alphabetical Order


Differentiating Myoglobinuria from Hemoglobinuria

After centrifuge, the serum of myologinuria is clear, where the serum of hemoglobinuria after centrifuge is pink.

 
 
 
 
 
 
 
Centrifuse Result
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sediment Red
 
 
 
 
 
 
 
Supernatant Red
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hematuria
 
 
 
 
 
 
 
Dipstick heme
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Negative
 
 
 
 
Positive
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
❑ Beeturia
❑ Phenazopyridine
❑ Porphyria
❑ Other
 
 
 
 
❑ Myoglobin
❑ Hemoglobin
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Plasma color
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Clear
 
 
 
 
 
Red
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Myoglobinuria
 
 
 
 
 
Hemoglobinuria

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