All 27 patients were suspected to have a metabolic myopathy. Enzyme defects were confirmed in 9 patients, including 4 cases of CPT II deficiency. Tsurui S et al, Clinical and biochemical analysis of 27 patients with myoglobinuria of unknown causes. Recurrent childhood myoglobinuria. We will continue to update this page as additional Triggers surveys are submitted through the interactive survey form.
Stress is the real X factor.
It can create major or minor episodes. Most major episodes are caused by multiple triggers i.e. mountain climbing the Grand Canyon with less food and water than ideal. I used to think that some episodes had no trigger, but I am finding links with menstruation. Most symptoms caused by hunger or dehydration. When I work on my car, my arms start hurting, then my back down to my legs.