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Laboratory markers used to diagnose both ER and rhabdomyolysis are very sensitive, but not very specific, and imperfectly distinguish \u201csubclinical\u201d or asymptomatic from severe, life-threatening illness. However, genetic factors, both recognized and yet to be discovered, likely influence this diverse clinical spectrum of disease and response to exercise. Genetic mutations causative for McArdle disease, carnitine palmitoyl transferase deficiency 2, myoadenylate deaminase deficiency, and malignant hyperthermia have all been associated with ER. Polymorphic variations in the myosin light chain kinase, \u03b1-actin 3, creatine kinase\u2013muscle isoform, angiotensin I-converting enzyme, heat shock protein, and interleukin-6 genes have also been associated with either ER or exercise-induced serum creatine kinase elevations typical of ER. The prognosis for ER is significantly better than that for other etiologies of rhabdomyolysis, but the risk of recurrence after an initial episode is unknown. Guidelines for management are provided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/cnd.0b013e31822721ca","type":"journal-article","created":{"date-parts":[[2012,2,22]],"date-time":"2012-02-22T05:50:41Z","timestamp":1329889841000},"page":"122-136","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":72,"title":["Exertional Rhabdomyolysis"],"prefix":"10.1097","volume":"13","author":[{"given":"Mark E.","family":"Landau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimbra","family":"Kenney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Deuster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20240808","doi-asserted-by":"crossref","first-page":"422","DOI":"10.3109\/s10165-004-0335-0","article-title":"Rhabdomyolysis and acute renal failure in a polymyositis patient.","volume":"14","author":"Tsai","year":"2004","journal-title":"Mod Rheumatol"},{"key":"R2-4-20240808","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/01.md.0000188565.48918.41","article-title":"Rhabdomyolysis: an evaluation of 475 hospitalized patients.","volume":"84","author":"Melli","year":"2005","journal-title":"Medicine (Baltimore)"},{"key":"R3-4-20240808","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/mus.10053","article-title":"Rhabdomyolysis: a review.","volume":"25","author":"Warren","year":"2002","journal-title":"Muscle Nerve"},{"key":"R4-4-20240808","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.nmd.2010.06.018","article-title":"Disorders of muscle lipid metabolism: diagnostic and therapeutic challenges.","volume":"20","author":"Laforet","year":"2010","journal-title":"Neuromuscul Disord"},{"key":"R5-4-20240808","first-page":"E4","article-title":"Postcompetition elevation of muscle enzyme levels in professional football players.","volume":"2","author":"Garry","year":"2000","journal-title":"MedGenMed"},{"key":"R6-4-20240808","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/BF01707664","article-title":"Rapid fall in blood myoglobin in massive rhabdomyolysis and acute renal failure.","volume":"20","author":"Wakabayashi","year":"1994","journal-title":"Intensive Care Med"},{"key":"R7-4-20240808","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1001\/archinte.1976.03630060044010","article-title":"Incidence of acute exertional rhabdomyolysis. 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