Differential Diagnosis for Rhabdomyolysis with Elevated Liver Enzymes
Single Most Likely Diagnosis
- Excessive Muscle Activity or Trauma: This is often the most common cause of rhabdomyolysis, which can lead to elevated liver enzymes due to the release of muscle breakdown products into the bloodstream. Activities such as marathon running, intense weightlifting, or any form of severe physical exertion can cause muscle damage.
Other Likely Diagnoses
- Statins and Other Cholesterol-Lowering Medications: Certain medications, especially statins, can cause muscle damage as a side effect, leading to rhabdomyolysis. Elevated liver enzymes can also occur due to the medication's effect on the liver.
- Infections (Viral, Bacterial): Certain infections can cause muscle and liver inflammation, leading to rhabdomyolysis and elevated liver enzymes. Viral infections like influenza and bacterial infections such as Legionnaires' disease are examples.
- Heat Stroke: Severe heat exposure can cause muscle damage and liver dysfunction, resulting in rhabdomyolysis and elevated liver enzymes.
Do Not Miss Diagnoses
- Toxin Exposure (e.g., Carbon Monoxide, Snake Venom): Exposure to certain toxins can cause severe muscle and liver damage. These conditions are less common but can be fatal if not promptly diagnosed and treated.
- Malignant Hyperthermia: A rare but life-threatening condition triggered by certain medications used in general anesthesia, leading to severe muscle damage and hyperthermia.
- Neuroleptic Malignant Syndrome: A rare, life-threatening neurological disorder caused by an adverse reaction to neuroleptic or antipsychotic medication, which can cause muscle rigidity and elevated liver enzymes.
Rare Diagnoses
- Muscle Phosphofructokinase Deficiency (Tarui Disease): A rare genetic disorder that affects the muscle's ability to break down glucose, leading to episodes of rhabdomyolysis.
- McArdle Disease (Glycogen Storage Disease Type V): A genetic disorder that affects the muscle's ability to break down glycogen, leading to muscle cramps, weakness, and potentially rhabdomyolysis after exercise.
- Wilson's Disease: A rare genetic disorder that leads to copper accumulation in the body, causing liver damage and potentially rhabdomyolysis in severe cases.