Abstract
Introduction: Rhabdomyolysis is the clinicopathologic presentation that is caused by striated muscle damage with leaking of toxic pigments into the blood. Clinical findings of rhabdomyolysis ranges from asymptomatic increase of muscle enzymes to the fatal forms of acute renal failure (ARF) and electrolyte disturbance. The causes of rhabdomyolysis can be classified under several groups: (a) direct injury from trauma, (b) overuse of muscle, (c) congenital muscle enzyme errors, and (d) uncommon pathogens like drugs and toxins, ischemia of muscle, metabolic and endocrine disorders, and finally infections. The diagnosis of rhabdomyolysis is based on myalgia and weakness, tea-colored urine (myoglobinuria), an increase in muscle enzymes that is not caused by myocardial infarction (MI) or polymyositis (PM). The most important goal of treatment is to diagnose and cure complications like electrolyte disturbances and acute tubular necrosis (ATN). Case Report: The case in the present study was a young man who was admitted with fever and chill and generalized myalgia with tea-colored urine. Finally, he died because of acute adult respiratory distress syndrome (RDS), acute renal tubular necrosis, and hyperkalemia. Among congenital muscle enzyme disorders, the most common type is the carnitine-palmitotransferase defect (CPT), and after that, the second most common is myophosphorylase deficiency. Among muscle carbohydrate metabolism defects, McArdle disease (MD), or glycogenosis type V (GSD-V), is the most prevalent, which is caused by a deficiency in glycogen-phosphorylase enzyme. In this disorder, only striated muscles are affected, which leads to rhabdomyolysis in the primary steps, and exercise intolerance, muscle cramps, and myoglobinuria, when reaches more developed levels. This predisposition to rhabdomyolysis in patients with MD prevents us from administrating certain drugs in these cases. Conclusion: Rhabdomyolysis may develop among individuals with abnormal muscles as in congenital diseases of glycogenolysis, glycolysis, purine, and lipid metabolism. Considering the rare causes of rhabdomyolysis like MD permits physicians to diagnose and treat this potentially fatal occult causes.