Myoglobinuria may result whenever dissolution of muscle sarcoplasm occurs. This phenomenon is classified as primary, a relatively rare disease of unknown etiology, or as secondary when precipitated by crush injury, arterial occlusion with ischemia, high-voltage electrical shock, severe burns, or ingestion by a susceptible person of a certain type of fish (Haff disease).
Primary myoglobinuria is probably more common than the approximate 58 reported cases suggest. Although usually precipitated by muscular exertion, such is not the case in a significant number of patients. Fever,1 infection,2 and electroshock therapy3 have been implicated as inducing this disorder. Korein et al.4 classify in a subgroup all cases of primary myoglobinuria not preceded by muscular exertion, designating this group idiopathic or toxic myoglobinuria.*
This case is of interest because of its association with the therapy of diabetic acidosis, because it is the first case in which electromyographic studies were done
RAINEY RL, ESTES PW, NEELY CL, AMICK LD. Myoglobinuria Following Diabetic Acidosis: With Electromyographic Evaluation. Arch Intern Med. 1963;111(5):564–571. doi:10.1001/archinte.1963.03620290030006
Best of JAMA Network 2022
Customize your JAMA Network experience by selecting one or more topics from the list below.