[edit]Causes
Alfred P. Murrah Federal Building after a 1995 bombing that injured or killed hundreds of people. Collapsing buildings can cause crush injuries that trigger rhabdomyolysis.
Anything that destroys muscle tissue can cause rhabdomyolysis. The causes of rhabdomyolysis are classified as either physical or non-physical. Physical rhabdomyolysis can be confined to a particular area of the body or affect all muscles simultaneously, depending on the cause.[1]
[edit]Physical causes
Recognized physical causes for rhabdomyolysis:[1]
Traumatic compression of muscles: crush syndrome (e.g., in earthquakes), car accident, confinement in a fixed position (e.g. after a stroke, due to drunkenness or in prolonged surgery), physical torture or abuse
Obstruction of blood supply to muscles: arterial thrombosis (blood clots forming locally) or embolism (clots or other debris from elsewhere in the body), clamping of an artery during surgery, generally reduced blood supply in shock or sepsis (due to any cause)
Excessive muscle strain or activity: extreme physical exercise (particularly when poorly hydrated), delirium tremens (alcohol withdrawal), tetanus, prolonged seizures or status epilepticus
Electrical: lightning, high-voltage electric shock, including electroshock weapon injuries[5]
[edit]Non-physical causes
Non-physical causes reported to cause rhabdomyolysis include:[1]
Disorders of muscle energy supply (usually hereditary enzyme problems): carnitine deficiency, CPT type I or type II deficiency, McArdle's disease, various defects in the mitochondrial respiratory chain, phosphofructokinase deficiency, VLCAD deficiency[6]
Poisons such as heavy metals and venom from insects or snakes
Foodborne toxins (e.g., coniine from quail that have consumed hemlock (coturnism),[7] Tricholoma equestre mushrooms in France and Poland,[8] and an unidentified toxin in fish (Haff disease)[9]))
Drugs of abuse,[10] including: ethanol,[11] methamphetamines,[12] cocaine,[13] heroin,[14] phencyclidine (PCP),[15] ketamine,[16] and MDMA (ecstasy)[17][18]
Medications:
Statins, especially when prescribed in combination with fibrates. Cerivastatin (Baycol) was withdrawn in 2001 after numerous reports of rhabdomyolysis. Other statins have a small risk of 0.44 cases per 10,000 patients annually, which increases to 5.98 if a fibrate is added.[19] However, other studies detected no increased risk from statins.[20]
Anti-psychotic medications may cause neuroleptic malignant syndrome, which can cause severe muscle rigidity with rhabdomyolysis and hyperpyrexia.
Neuromuscular blocking agents used in anesthesia may cause malignant hyperthermia, also associated with rhabdomyolysis.
Medications that interfere with potassium levels (e.g., diuretics)
Infections: Coxsackie virus, Plasmodium falciparum (malaria), herpes viruses, Legionella pneumophila, Salmonella and Francisella tularensis (tularemia)
Electrolyte and metabolic disturbances: increased plasma osmolality, hyper- and hyponatremia (elevated or reduced blood sodium levels), hypokalemia (low potassium levels), hypocalcemia (low calcium levels), hypophosphatemia (low phosphate levels), ketoacidosis (e.g., in diabetes) or hypothyroidism (abnormally low thyroid function)
Autoimmune muscle damage: polymyositis, dermatomyositis
[edit]Diagnosis
The first thing I thought of when I saw the story yesterday was if it could be related to steroid use. I didn't see that as a cause but the second post in the thread is pretty hard to read in the format its in. Anyone know if any type of doping could cause something like this?
Contrary to what this doctor is saying, rhsbdomyolysis is NOT a "diagnosis commonly seen". That's absolutely ridiculous.
My first guess is that they took some supplement they all bought at the local GNC that is a diuretic.
http://www.hellenicjcardiol.com/archive/full_text/2003/1/2003_1_80.pdf
13 guys just don't all work out too hard at the same time.
Had about 20 kids get this in early pre-seasn last August.
My guess is some sort of stimulant with pain killers and a strong anti-inflammatory. Methamphetamines + Vicodin + prednisone?
They could have just down a bunch of Red Bull or 5 Hour Energy with some Motrin and decided to go "balls out" for the workout.
Their kidneys shutting down makes it suspicious for an NSAID/motrin type product.
The Bodybuilding.com forum probably has some better ideas.
I'm sure they were doing drugs together, like marijuana or cocaine or something of a similar nature.
Oregon HS football team wrote:
Had about 20 kids get this in early pre-seasn last August.
Because about 20 Oregon white trash football idiots all decided to take drugs and play football. Not hard to figure out.
lol
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