Case reports of athletes affected by rhabdomyolysis: A systematic review

Abstract

Objective To analyze intensity levels, modalities, types of physical activities, ambient temperature, and hydration levels during stimuli performed in training and competitionof studies that reported episodes of rhabdomyolysis in athletes. Method We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO, as number CRD42020126107. MedLine (via PubMed), Cochrane, LILACS, SciELO, Web of Science, Scopus, CINAHL, SPORTDiscus, ScienceDirect, and PEDro databases were searched for case reports in which professional athletes, who had a technical team as support, were affected by rhabdomyolysis induced by the practice of physical activity. The descriptors and their synonyms “rhabdomyolysis”, “exercise”, and “athletes”, available in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), were used. Results After the screening process, 10 studies were includedand analyzed according to the CAse REport (CARE) guidelines.The sports of the case reports were soccer, football, swimming, wrestling, 24-hour cross-country skiing, and mixed martial arts (MMA).The age range of the athletes varied between 16 to 41 years old. The case reports described a total of 17 athletes (14 male and three female).The main aspects related to the diagnosis of rhabdomyolysis were ambient temperature, creatine kinase (CK) levels, the occurrence of renal impairment, and one or more signs of the classical triad (myalgia, dark urine, and muscle weakness). Conclusion It was observed difficulty in identifying concrete parameters to prevent and diagnose the rhabdomyolysis of premature form, however, controlling these variables may increase the chances of treatment success and decrease the risk of sequels.

Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review

“…reviews evaluating other types of ER 42,43 , there has been no systematic review of SIER to date. In our systematic review, we describe the clinical characteristics and outcomes of 97 patients with SIER.…”

Exercise-induced rhabdomyolysis manifestations and complications: a case report

“…Unaccustomed, sudden, heavy, and prolonged physical exercise can induce rhabdomyolysis 6 . Myalgia/pain, muscle weakness, local swelling, myoglobinuria (tea-colored dark urine), and fatigue within 24–48 h postphysical activity are typical presentations of exRML 1 , 6 , 7 . Elevation of CK to more than 1000 IU/l, which is about five times the upper limit of the normal level, combined with a history of recent vigorous or prolonged physical activity, should raise suspicion of ExRML 1 , 4 , 7 .…”

“…Myalgia/pain, muscle weakness, local swelling, myoglobinuria (tea-colored dark urine), and fatigue within 24–48 h postphysical activity are typical presentations of exRML 1 , 6 , 7 . Elevation of CK to more than 1000 IU/l, which is about five times the upper limit of the normal level, combined with a history of recent vigorous or prolonged physical activity, should raise suspicion of ExRML 1 , 4 , 7 . CK levels of more than 5000 IU/l indicate severe muscle injury and an increased risk of complications 1 , 4 , 6 .…”