{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:14:36Z","timestamp":1791357276191,"version":"4.3.1"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,9,23]]},"abstract":"<jats:p>Despite the majority of patients with McArdle disease reporting symptoms including fatigue, cramps and episodes of myoglobinuria from early childhood, diagnosis is often delayed by several decades. Additionally, many individuals with rhabdomyolysis remain undiagnosed. The occurrence of symptoms during exercise, particularly isometric muscle contraction such as heavy lifting, is well known in McArdle disease. However, isometric muscle contraction that occurs with emotion is not recognised as exercise and may be missed as a trigger for rhabdomyolysis, potentially leading to a delay in diagnosis. Three patients are presented here, all with symptoms from childhood including episodes of rhabdomyolysis induced by tense emotional situations without physical exertion; two patients reported recurrent episodes while watching rather than playing football. The remaining patient developed rhabdomyolysis during a heated argument. These patients\u2019 histories emphasise the risk from sustained isometric muscle contraction that occurs in emotive situations for patients with McArdle disease.<\/jats:p>","DOI":"10.1136\/bcr-2013-203272","type":"journal-article","created":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T07:58:08Z","timestamp":1412668688000},"page":"bcr2013203272","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Emotionally-intense situations can result in rhabdomyolysis in McArdle disease"],"prefix":"10.1136","volume":"2014","author":[{"given":"Stefen","family":"Brady","sequence":"first","affiliation":[{"name":"Department of Neuropathology, MRC Centre for Neuromuscular Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Centre of Human Performance and Sports Medicine, Brunel University, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata S","family":"Scalco","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, MRC Centre for Neuromuscular Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ros M","family":"Quinlivan","sequence":"additional","affiliation":[{"name":"MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,10,7]]},"reference":[{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-301593"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.195040"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091130"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.4","first-page":"583","article-title":"Emotional distress induced rhabdomyolysis in an individual with carnitine palmitoyl-transferase deficiency","volume":"19","author":"Wallace","year":"2001","journal-title":"Clin Exp Rheumatol"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005553907216"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.6","first-page":"CD007931","article-title":"Physical training for McArdle disease","volume":"12","author":"Quinlivan","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082623232966000_2014.oct07_1.bcr2013203272.7","unstructured":"Wakelin A . 101 Tips for a good life with McArdle disease. Association for Glycogen Storage Diseases (UK) Ltd, 2013."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-203272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:23:40Z","timestamp":1756275820000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-203272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,7]]},"references-count":7,"alternative-id":["10.1136\/bcr-2013-203272"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-203272","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,7]]}}}