ironjustice
2008-07-16 14:50:18 UTC
Published ahead of print on April 23, 2008
Clin J Am Soc Nephrol 3: 1022-1027, 2008
(c) 2008 American Society of Nephrology
doi: 10.2215/CJN.04491007
--------------------------------------------------------------------------------
Clinical Nephrology
Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular
Hemolysis
Diego Tobal*, Alicia Olascoaga, Gabriela Moreira, Melania Kurdián*,
Fernanda Sanchez, Maria Roselló*, Walter Alallón, Francisco Gonzalez
Martinez*, and Oscar Noboa*,
* Centro de Nefrología, Laboratorio Clínico, Departamento de
Fisiopatología, Hospital de Clínicas, Facultad de Medicina Universidad
de la República, Montevideo, Uruguay
Correspondence: Dr. Oscar Noboa, Depto de Fisiopatología Hospital de
Clinicas, Avda Italia s/n 11609, Montevideo, Uruguay. Phone/Fax:
5982-4809850; E-mail: ***@hc.edu.uy
Background and objectives: During Carnival, groups of 60 drummers go
drumming with their hands and marching for periods of 2 to 4 h. The
objective of this study was to determine the frequency and type of
urinary abnormalities after candombe drumming and to evaluate possible
pathogenic mechanisms.
Design, setting, participants, & measurements: For analysis of
pathogenic mechanisms, a group of individuals were prospectively
evaluated before and after candombe drumming.
Methods: Candombe drummers were recruited in January 2006, 1 wk before
prolonged drumming. After clinical evaluation, urine and blood samples
were obtained before and immediately after drumming.
Results: Forty-five healthy individuals (four women and 41 men),
median age 31 yr (14 to 56), were evaluated. Predrumming urine and
plasma samples were obtained for 30 individuals. Nineteen (42%) of 45
had a previous history of rust urine emission temporally related with
candombe drumming. After drumming, 18 of 26 showed urine
abnormalities; six of 26 showed rust urine, eight of 26 had
microhematuria, and seven of 26 had proteinuria >1 g/L. The candombe
drummers who showed rust urine after heavy drumming presented
significantly higher levels of lactate dehydrogenase and total
bilirubin when compared with those without urine abnormalities.
Haptoglobin was significantly lower in the rust urine group.
Fragmented red cells were observed in the blood smear of individuals
with rust urine. Rust urine after drumming was associated with
previous episodes of rust urine and glucosuria.
Conclusions: Taken together, these data confirm that rust urine is
caused by extracorpuscular hemolysis.
--------------------------------
Med Sci Monit. 2008 Jan;14(1):CS1-4. Links
Myoglobinuria caused by exertional rhabdomyolysis misdiagnosed as
psychiatric illness.
Banasik M, Kuźniar J, Kusztal M, Porazko T, Weyde W, Klinger M.
Department of Nephrology and Transplantation Medicine, Wrocław Medical
University, Wrocław, Poland. ***@interia.pl
BACKGROUND:
Rhabdomyolysis is severe and acute skeletal muscle damage resulting in
sarcolemma disruption. During injury, intracellular muscle contents
are released into the plasma. The consequences may cause hypovolemia,
electrolyte abnormalities, compartment syndrome, or even acute renal
failure and dialysis. CASE REPORT:
We present the history of a patient in whom exertional rhabdomyolysis
was misdiagnosed. A 20-year-old male police recruit was admitted to a
psychiatric hospital because of complaints about black urine and
severe thigh pain.
Serum creatinine kinase (CK) was significantly elevated at 87,335 U/
l.
Urinalysis showed brown color and cloudiness.
Serum myoglobin was also significantly increased.
Aspartate aminotransferase was elevated as was alanine
aminotransferase. Immediate intravascular fluid hydration and hospital
rest under renal, metabolic, and hematological monitoring was
performed.
CONCLUSIONS:
Gymnastic teachers and people at environmental risk of rhabdomyolysis,
such as members of the armed forces, police, and supervisors of
physical laborers, need to remember the risks of intensive and
repetitive exercise.
Symptoms such as dark urine, myalgia, and muscle weakness should
immediately arouse suspicion of rhabdomyolysis.
Especially dark-colored urine should always be investigated for the
occurrence of rhabdomyolysis.
PMID: 18172418 [PubMed - indexed for MEDLINE]
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/4rq595
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
Clin J Am Soc Nephrol 3: 1022-1027, 2008
(c) 2008 American Society of Nephrology
doi: 10.2215/CJN.04491007
--------------------------------------------------------------------------------
Clinical Nephrology
Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular
Hemolysis
Diego Tobal*, Alicia Olascoaga, Gabriela Moreira, Melania Kurdián*,
Fernanda Sanchez, Maria Roselló*, Walter Alallón, Francisco Gonzalez
Martinez*, and Oscar Noboa*,
* Centro de Nefrología, Laboratorio Clínico, Departamento de
Fisiopatología, Hospital de Clínicas, Facultad de Medicina Universidad
de la República, Montevideo, Uruguay
Correspondence: Dr. Oscar Noboa, Depto de Fisiopatología Hospital de
Clinicas, Avda Italia s/n 11609, Montevideo, Uruguay. Phone/Fax:
5982-4809850; E-mail: ***@hc.edu.uy
Background and objectives: During Carnival, groups of 60 drummers go
drumming with their hands and marching for periods of 2 to 4 h. The
objective of this study was to determine the frequency and type of
urinary abnormalities after candombe drumming and to evaluate possible
pathogenic mechanisms.
Design, setting, participants, & measurements: For analysis of
pathogenic mechanisms, a group of individuals were prospectively
evaluated before and after candombe drumming.
Methods: Candombe drummers were recruited in January 2006, 1 wk before
prolonged drumming. After clinical evaluation, urine and blood samples
were obtained before and immediately after drumming.
Results: Forty-five healthy individuals (four women and 41 men),
median age 31 yr (14 to 56), were evaluated. Predrumming urine and
plasma samples were obtained for 30 individuals. Nineteen (42%) of 45
had a previous history of rust urine emission temporally related with
candombe drumming. After drumming, 18 of 26 showed urine
abnormalities; six of 26 showed rust urine, eight of 26 had
microhematuria, and seven of 26 had proteinuria >1 g/L. The candombe
drummers who showed rust urine after heavy drumming presented
significantly higher levels of lactate dehydrogenase and total
bilirubin when compared with those without urine abnormalities.
Haptoglobin was significantly lower in the rust urine group.
Fragmented red cells were observed in the blood smear of individuals
with rust urine. Rust urine after drumming was associated with
previous episodes of rust urine and glucosuria.
Conclusions: Taken together, these data confirm that rust urine is
caused by extracorpuscular hemolysis.
--------------------------------
Med Sci Monit. 2008 Jan;14(1):CS1-4. Links
Myoglobinuria caused by exertional rhabdomyolysis misdiagnosed as
psychiatric illness.
Banasik M, Kuźniar J, Kusztal M, Porazko T, Weyde W, Klinger M.
Department of Nephrology and Transplantation Medicine, Wrocław Medical
University, Wrocław, Poland. ***@interia.pl
BACKGROUND:
Rhabdomyolysis is severe and acute skeletal muscle damage resulting in
sarcolemma disruption. During injury, intracellular muscle contents
are released into the plasma. The consequences may cause hypovolemia,
electrolyte abnormalities, compartment syndrome, or even acute renal
failure and dialysis. CASE REPORT:
We present the history of a patient in whom exertional rhabdomyolysis
was misdiagnosed. A 20-year-old male police recruit was admitted to a
psychiatric hospital because of complaints about black urine and
severe thigh pain.
Serum creatinine kinase (CK) was significantly elevated at 87,335 U/
l.
Urinalysis showed brown color and cloudiness.
Serum myoglobin was also significantly increased.
Aspartate aminotransferase was elevated as was alanine
aminotransferase. Immediate intravascular fluid hydration and hospital
rest under renal, metabolic, and hematological monitoring was
performed.
CONCLUSIONS:
Gymnastic teachers and people at environmental risk of rhabdomyolysis,
such as members of the armed forces, police, and supervisors of
physical laborers, need to remember the risks of intensive and
repetitive exercise.
Symptoms such as dark urine, myalgia, and muscle weakness should
immediately arouse suspicion of rhabdomyolysis.
Especially dark-colored urine should always be investigated for the
occurrence of rhabdomyolysis.
PMID: 18172418 [PubMed - indexed for MEDLINE]
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh
Man Is A Herbivore!
http://tinyurl.com/4rq595
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk