5 doctors weighed in:

Skeletal muscle loss/ischemia evident by high myoglobin in urine (25). What are the markers for myalgia vs neuropathy? Patient on gabapentin and decreased gfr (20), cymbalta was discontinued for low gfr. Which specialist would be best for the issue?

5 doctors weighed in
Dr.
1 doctor agrees

In brief: Painful muscles

Hi JahanaraC, your primary doctor can check a CK (creatnine kinase).
This is a good indicator of muscle breakdown. If there is, your doctor may refer you to a rheumatologist/internal medicine doctor. If it is normal, then a neurologist may be more appropriate. Hope that helps.

In brief: Painful muscles

Hi JahanaraC, your primary doctor can check a CK (creatnine kinase).
This is a good indicator of muscle breakdown. If there is, your doctor may refer you to a rheumatologist/internal medicine doctor. If it is normal, then a neurologist may be more appropriate. Hope that helps.
Dr.
Thank
1 doctor agrees

In brief: Concerns.

Usually urine myoglobin levels indicate rhabdomyolysis, which may well indicate a primary inflammatory muscle disease.
Although basic CK and aldolase measures might help, you may well require EMG and even muscle biopsy. The presence of kidney failure raises concern for many systemic disorders. I think a nephrologist is a very good starting point.

In brief: Concerns.

Usually urine myoglobin levels indicate rhabdomyolysis, which may well indicate a primary inflammatory muscle disease.
Although basic CK and aldolase measures might help, you may well require EMG and even muscle biopsy. The presence of kidney failure raises concern for many systemic disorders. I think a nephrologist is a very good starting point.
Dr. Bennett Machanic
Dr. Bennett Machanic
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Dr. John Goldman
Internal Medicine - Rheumatology
1 doctor agrees

In brief: Need more informatio

What are the muscle enzymes CPK and Aldolase.
Are they elevated sicne there is urine myoglobin. If the myoglobin is elevated this suggests that the myalgia may be a myositis. Neuropathy is something different. Ask your physician about seeing a neurologist for the neuropathy and a nephrologist for the kidney. You may need others.

In brief: Need more informatio

What are the muscle enzymes CPK and Aldolase.
Are they elevated sicne there is urine myoglobin. If the myoglobin is elevated this suggests that the myalgia may be a myositis. Neuropathy is something different. Ask your physician about seeing a neurologist for the neuropathy and a nephrologist for the kidney. You may need others.
Dr. John Goldman
Dr. John Goldman
Thank
Dr. Dean Giannone
Internal Medicine

In brief: Complex issue.

You're asking a very complex question.
As far as a specialist is concerned, I feel a Rheumatologist would serve you best given your questions and considerations.

In brief: Complex issue.

You're asking a very complex question.
As far as a specialist is concerned, I feel a Rheumatologist would serve you best given your questions and considerations.
Dr. Dean Giannone
Dr. Dean Giannone
Thank
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