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Q J Med 1995; 88: 811-817
© 1995 Association of Physicians

Chronic alcoholic myopathy: diagnostic clues and relationship with other ethanol-related diseases

E. SACANELLA, J. FERNÁNDEZ-SOLÀ, M. COFAN, J.-M. NICOLAS, R. ESTRUCH, E. ANTÚNEZ and A. URBANO-MÁRQUEZ

Alcohol Unit and Muscle Research Groups, Department of Internal Medicine, Hospital Clfnic i Provincial, University of Barcelona Barcelona, Spain

Address correspondence to Dr J. Fernandez-Solà, Alcohol Unit and Muscle Research Groups, Department of Internal Medicine, Hospital Clfnic i Provincial, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain

Received 30 March 1995 Accepted for publication 22 May 1995.


  Abstract

We report the clinical, laboratory, functional and histological features of 100 male alcoholic patients of whom 44 had chronic alcoholic myopathy (CAM). We evaluated the use of non-invasive tests in detecting CAM, and examined its relationship with other ethanol-related diseases such as cirrhosis and cardiomyopathy. Of the CAM patients, 24 (55%) presented clinical symptoms of myopathy, whereas proximal muscle atrophy was observed in 15 patients (35%). Thirty-seven (80%) had significantly decreased muscle strength by myometric measurement and 27 (60%) hadabnormally increased serum muscle enzymes. In most of these patients, the myopathy was classified as mild. The most frequent histological findings were myocytolysis, fibre size variabilityand type II fibre atrophy. As there was a good correlation betweenclinical symptoms, decreased muscle strength on myometry and histological evidence of CAM, muscle biopsy may be avoidablein some of these patients. Cardiomyopathy and liver cirrhosis were more frequent in patients with CAM, and should be checked for in chronic alcoholics with skeletal myopathy.


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