Myoglobinuria and Persistence of Fetal Myoglobin

Myoglobin and Muscular Dystrophy

“…At about the same time, Kossman et al4 and Benoit5,6 described rapidly migrating forms of myoglobin in starch gel electrophoresis of urine during attacks of myoglobinuria; they suggested that these were either abnormal forms of the pigment4 or represented fetal myoglobin. 5,6 Using starch gel electrophoresis and chromatographic-electrophoretic fingerprints of tryptic digests, Boyer and Fainer7 had pre¬ viously identified genetic alterations of myo¬ globin in two families, but these abnor¬ malities were not associated with clinical myopathy. Perkoff8 had also completed a detailed biochemical study of normal hu¬ man myoglobin and found multiple forms of myoglobin on column chromatography, with abnormal preponderance of a fetal form of myoglobin in Duchenne dystro¬ phy.9 (The fetal myoglobin reacted with antibodies prepared against adult myoglo¬ bin but behaved differently in immunodiffusion studies, whether isolated from fe¬ tal muscle or from urine during attacks of pigmenturia.10·11) Rowland et al12 however, showed that the rapidly migrating forms found in myoglobinuria might also appear in extracts of normal human muscle.…”

Idiopathic rhabdomyolysis

“…Some authors (Haase and Engel, 1960;Reiner et al, 1956;Larsson et al, 1964;and Kossmann, Camp, and Engle, 1963) describe evidence of regeneration such as sarcoplasmic basophilia, proliferation of sarcolemmal nuclei, and the presence of multinucleate giant cells, but there was no suggestion of this in our Case 2 and there was no RNA activity on Azur B staining. Benoit, Theil, and Watten (1964), Hinz, Drucker, and Lamer (1965), and Tavill et al (1964) describe little change in the muscle in their reports, and the light microscopical appearance of the muscle biopsy of our Case 3 was essentially normal. Cardiac and smooth muscle are unaffected.…”

“…Benoit et al (1964) recorded such a case and Perkoff (1964) found increased concentration of fetal protein in the muscle of a patient with myoglobinuria. However, more recently on reexamination of his preparations, Perkoff has confirmed the observation of others (Wolfson et 1-967) that the major haemoprotein was fetal haemoglobin and he believes that reports of fetal myoglobin in patients with myoglobinuria must be considered to have alternative explanations (Perkoff, 1968).…”