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A 33-year-old man was hospitalized during an attack of disabling pain in his extremities. Similar attacks, accompanied by the passage of dark urine, had occurred repeatedly during the previous 10 years and had twice led to hospitalization. They had always followed ingestion of large amounts of alcoholic beverages. Immunoelectrophoresis of the urine, using human myoglobin antiserum, positively identified the pigment in the urine as myoglobin. Like other patients who have exhibited transient, nonspecific electrocardiographic changes, this patient showed a variety of dynamic electrocardiographic changes during the acute attacks, and there was radiologic evidence of cardiomegaly.
Erlenborn JW, Pilz CG. Paroxysmal Myoglobinuria: Associated with Cardiomegaly and Electrocardiographic Abnormalities. JAMA. 1962;181(13):1111–1114. doi:10.1001/jama.1962.03050390013004
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