Cholestasis and Myotonic Dystrophy

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Abstract
To the Editor: Myotonic dystrophy (Steinert's disease) is an uncommon disorder of unknown cause, with involvement of smooth and striated muscle.1 We have observed an unusual manifestation, anicteric cholestasis, in two patients with this disease.A 49-year-old woman was admitted to the hospital after reporting weakness of the limbs. The diagnosis of myotonic dystrophy was made on clinical, electrophysiologic and histologic grounds. There was no alcoholism, no drug intake and no pruritus. The liver and the spleen were not palpable; there were no clinical features of hepatocellular failure or portal hypertension. The total bilirubin level was 0.6 mg per 100 . . .