March hemoglobinuria

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As Marschhämoglobinurie one by the presence of the blood pigment is hemoglobin in the urine ( hemoglobinuria resulting) brownish discoloration referred to, which plays no clinical significance. The finding occurs mostly as an incidental finding in urine tests if physical exertion, such as long, hard marches, marathons, hand drumming or other heavy physical work, preceded the sampling. The name of the phenomenon is derived from this fact. Marsh hemoglobinuria was first described by R. Fleischer in 1881. The similar term sports hemoglobinuria , which should not be confused with sports hematuria , is more common today.

In march hemoglobinuria, red blood pigment ( hemoglobin ) is excreted by the kidneys for several hours after about one to three hours after strenuous physical exertion . Damage to the red blood cells ( hemolysis ) is assumed to be the cause of this . On long walks, the traumatic destruction of the erythrocytes by the pressure on the soles of the feet is probably the cause, i.e. mechanical damage ( torquing ) of the red blood cells as a result of eddy formation in the capillaries of the sole of the foot with intravascular haemolysis. The extent of hemolysis is clearly determined by the running style and the nature of the floor. As a preventive measure, wearing soft shoe insoles has proven itself.

March hemoglobinuria must be differentiated from March hematuria , which presumably has similar causes. Here, more erythrocytes and less hemoglobin are found in the urine than in marsh hemoglobinuria.

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  1. ↑ D. Tobal et al .: Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis . In: Clinical Journal of the American Society of Nephrology . No. 3 , 2008, p. 1022-1027 ( abstract ).
  2. ^ Willibald Pschyrembel: Clinical Dictionary , 256th edition, de Gruyter Verlag, Berlin, New York 1990, ISBN 3-11-010881-X , p. 1026.
  3. ^ R. Fleischer: About a new form of hemoglobinuria in humans. In: Berliner Klinische Wochenschrift . No. 47, 1881.
  4. ↑ Walter Siegenthaler et alii (ed.): Textbook of internal medicine , Georg Thieme Verlag , 3rd edition, Stuttgart, New York 1992, ISBN 3-13-624303-X , p. 685.
  5. ↑ Maxim Zetkin , Herbert Schaldach: Lexikon der Medizin , 16th edition, Ullstein Medical, Wiesbaden 1999, ISBN 978-3-86126-126-1 , p. 1244.