Korean J Blood Transfus.  2007 Dec;18(3):265-268.

A Case of Removal Myoglobin by Plasmapheresis in Rhabdomyolysis

• Jang MS
• Min Y
• Seo HA
• Park SJ
• Ko TS
• Kwon SW

Abstract

Rhabdomyolysis is defined as necrosis of the skeletal muscle fibers with release of the intracellular muscle constituents, including myoglobins,into the blood and urine. Severe myoglobinemia causes obstruction and necrosis of the renal tubule, resulting in acute renal failure (ARF). In this case, a patient with rhabdomyolysis-induced ARF was in recovery phase after treatment with fluid replacement and continuous renal replacement therapy (CRRT). However, a sudden relapse of severe myoglobinemia occurred during CRRT. To remove myoglobinas rapidly as possible, we applied two sessions of plasmapheresis (total plasma exchange, TPE) in addition to CRRT for two days. The myoglobin level of the patient successfully decreased by 91%, and clinical symptoms and laboratory-measuredabnormalities subsequently improved. If severe myoglobinemia is persistent, or if relapse in spite of CRRT occurs, it would be reasonable to consider TPEas an additional therapy.

Keyword

Rhabdomyolysis; Myoglobin; Plasmapheresis; TPE

MeSH Terms

Acute Kidney Injury
Humans
Muscle Fibers, Skeletal
Myoglobin*
Necrosis
Plasma Exchange
Plasmapheresis*
Recurrence
Renal Replacement Therapy
Rhabdomyolysis*
Myoglobin