Myoglobinuria in man may follow muscle injury by direct mechanical trauma and ischemia due to vascular occlusion. Seven reports have appeared of the syndrome associated with muscular dystrophies, and it may appear in epidemic form as "Haff disease." 1,2 There are, however, cases of myoglobinuria that cannot be attributed to any known underlying disorder. Twenty-one such cases, designated "idiopathic paroxysmal myoglobinuria," have appeared in the literature; the last was reported in 1957.3 There are, undoubtedly, many additional cases that are either not recognized, or not reported. The general aspects of myoglobinuria have been the subject of extensive reviews by Spaet, Rosenthal, and Dameshek4; Reiner et al.5; Biorck,6 and others.
In a recent in vitro study by Javid, Fischer, and Spaet,7 comparing the binding of hemoglobin and of myoglobin in plasma, it was demonstrated that myoglobin is not bound by the serum mucoprotein, haptoglobin. Extensive studies by several groups have established
JAVID J, HOROWITZ HI, SANDERS AR, SPAET TH. Idiopathic Paroxysmal MyoglobinuriaReport of a Case with Studies on Serum Haptoglobin Levels. AMA Arch Intern Med. 1959;104(4):628-633. doi:10.1001/archinte.1959.00270100114020