CASE REPORTS

IDIOPATHIC PAROXYSMAL MYOGLOBINURIA is a rare syndrome consisting basically of the spontaneous onset of muscle pa in and swelling followed by myoglobinuria and frequently com-plicated by oliguria or anur ia due to myoglobin-induced renal damage. T h e muscles most fre-quent ly affected are the muscles of the calf and the thigh, b u t abdominal, thoracic, cervical, masseter, and u p p e r extremity muscle groups have also been involved. Associated symptoms in some cases include fever, chills, abdominal pain, diarrhea, vomiting, and pseudoparalysis of the affected muscle groups. Almost all of the repor ted cases have shown some degree of renal involvement, varying from albuminur ia, cylin-druria, and oliguria to the passage of red cell casts, complete anuria, uremia, and death. Various degrees of "pur i ty " of the syndrome exist among the repor ted cases, ranging from those associated with other possible causes such as t rauma, alcoholism, myositis, and muscular dystrophy, to those wi thout apparen t cause, unassociated with other diseases, and having paroxysmal, recurrent attacks. T h e r e have been approximately 25 cases of this type repor ted in the 45 collected from the l i terature. T h e present case belongs in this lat ter category and is the fourth case to be repor ted in a Negro. W e will also present some thoughts on the possible etiology of this disease