Exercise rhabdomyolysis in military aircrew: Two cases and a review of aeromedical disposition

Introduction: Exercise rhabdomyolysis (ER) is a rare, sometimes catastrophic condition where muscle fibers breakdown in response to exertion and release their breakdown products into the circulation. While ER was brought to the medical community's attention largely through reports from military training establishments Lye are unaware of ER having resulted from the activities of military aircrew. This paper reports two cases of ER in military aircrew and discusses the condition and the approaches taken in determining their future aeromedical disposition. Case Reports: Rhabdomyolysis occurred in two military pilots as a result of their aircrew duties. One, an experienced pilot, suffered rhabdomyolysis as a result of centrifuge based G-training, while the other, a cadet in training, suffered rhabdomyolysis precipitated by exertion during moderately warm weather. Further investigation revealed the second case to also have the Malignant Hyperthermia Trait. Aeromedical Disposition: After wide consultation and lengthy deliberations both of these aircrew were returned to their Full previous flying status. No further complications or recurrences have occurred.