Myoglobinuria

The pathological presence of myoglobin in urine, resulting from skeletal muscle fiber breakdown and release of intracellular myoglobin into the circulation, typically occurring in rhabdomyolysis and potentially causing pigment-induced acute kidney injury when severe or prolonged.

Causes

• Trauma

  • Crush injury

  • Severe burns

  • Electrical injury

  • Prolonged immobilization or compression

  • Compartment syndrome

• Extremely strenuous exercise

• Medications and toxins causing myotoxicity

  • Alcohol abuse

  • Cocaine

  • Statins

• Infections causing myositis

  • Influenza

  • Human immunodeficiency virus (HIV)

• Metabolic and electrolyte causes

  • Hypokalemia

  • McArdle disease (glycogen storage disease type V)

  • Carnitine palmitoyltransferase (CPT) deficiency

  • Other inherited metabolic myopathies

• Neurological causes

  • Seizures

  • Prolonged muscle contractions

  • Hyperthermic syndromes

• Environmental and systemic causes

  • Heatstroke/hyperthermia

  • Sepsis

  • Autoimmune inflammatory myopathies

• Ischemic muscle injury