ALCOHOLIC SKELETAL MYOPATHY, A CLINICAL AND PATHOLOGICAL-STUDY

  • 1 January 1985
    • journal article
    • research article
    • Vol. 55  (218) , 233-251
Abstract
One hundred an fifty-one impatients with a history of chronic heavy alcohol intake were examined for evidence of muscle disease. Ninety-two patients (60%) had histologically abnormal biopsies of the quadriceps muscle. The most common abnormality, which was often severe, was type II muscle fiber atrophy. Seven patients (5%) had histological evidence of acute myopathy, 1 of whom presented with the full clinical picture of acute rhabdomyolysis. Twenty-thre patients had cirrhosis, 36 were significantly malnourished and 98 had evidence of a peripheral neuropathy. None of these features, were suffficient to account for the muscle abnormalities. There was no clear relationship between musculo-skeletal symptoms and muscle biopsy histology. Serum creatine kinase activity was elevated in only 23 subjects and was an insenstive indicator of sublincial acute myopathy and of chronic alcoholic myopathy. Follow-up studies after abstinence from alcohol invariably showed both objective and subjective improvement of muscle function- often in the absence of any clinical recovery from the peripheral neuropathy. Continued alcohol consumption was accompanied by persistence and often deterioration of muscle fiber atrophy. Chronic skeletal myopathy is evidently a frequent consequence of alcohol abuse and may result from a direct toxic effect of ethanol on muscle fibers.

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