A Spectrum of Myopathy Associated with Alcoholism

Abstract

Clinical and laboratory abnormalities are described in 59 alcoholic patients without muscular complaints studied after admission for acute alchoholic intoxication, in an additional patient with a reversible acute muscular syndrome characterized by muscle cramps and tenderness, in 1 patient with gross myoglobinuria and alcoholism, and in 10 patients with a chronic myopathy. The high incidence of elevated serum creatine phosphokinase and the reduced ability to raise blood lactic acid in response to ischemic exercise reported previously are confirmed in this larger group of patients. The clinical features of the chronic myopathy included proximal and diffuse muscle atrophy and weakness, which frequently were progressive and associated with muscle tenderness. A more stable form with proximal wasting unassociated with tenderness was also observed. Biochemical changes in the patients with chronic myopathy were similar to those in patients shortly after admission for acute intoxication and in the patients with acute myopathy, but they were less striking and less consistent. Abstinence from drinking was associated with improvement in every instance where the patient could be followed. The mechanism underlying the myopathy is unknown.