English 
Italian CASI CLINICI – Case Reports
Volume:
Biochimica Clinica 2014; 38(4) 344-346
Pubblicato on-line:
DOI:
L’esame automatizzato delle urine come approccio “bottom-up” per la diagnosi di rabdomiolisi
AUTORI
1Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria “Santa Maria della Misericordia”, Udine
2Instrumentation Laboratory SpA, Milano
ABSTRACT
Automated urinalysis as a bottom-up approach to rhabdomyolysis diagnosis
Rhabdomyolysis is a clinicopathological situation of heterogeneous origin, characterized by skeletal muscle damage followed by the release into the circulation of various myocyte components, including myoglobin. This small protein, which plays a pivotal role in the myocyte function, is easily filtered through the glomerulus in the urine, representing a potential factor of tubular toxicity. In this report, we describe three cases in which standard urine samples were analyzed with the integrated system iRICELL 3000 (Beckman Coulter): the observed discrepancy between a strong strip positivity for hemoglobin and an absent hematuria induced to perform an immunoassay measurement of myoglobin, leading to a well grounded suspect of rhabdomyolysis. The management of patients was thus optimized, suggesting to clinicians the elements for a rapid diagnosis.