Myoglobinuria: presentation of personal cases and review of the literature.

The presence of myoglobin in the urine is a symptom of rhabdomyolysis occurring in many muscular affections. Muscle tissue from seven patients who had presented one of more episodes of myoglobinuria has been studied by histological, histochemical, and biochemical methods. Three cases belonging to the same family and an additional one revealed a muscular CPT deficiency. Two of those cases were females. In two other cases a toxic etiology was suggested, one due to heroin and the other to associated fenfluramine and phenformin. In the last case the origin of rhabdomyolysis was not clearly defined and viral infection, drug intolerance or electrolytic imbalance were proposed. The cases are discussed in the light of the literature and the possible etiopathogenetic mechanisms are reviewed.