alcoholism with acute myopathy

Q: 42 years old male with history of alcoholism is admitted to ICU with acute myopathy. Which muscles are more prone to get effected? (select one)

A) distal

B) proximal

Answer: B

Patients may develop acute myopathy during an alcoholic binge if superimposed with no eating. Symptoms include weakness, pain, tenderness, and swelling of affected muscles. Proximal muscles tend to be more effected. For unknown reason, males get effected with high proportion. In its severe form it involves smooth and cardiac muscles leading to dysphagia, arrhythmias and congestive heart failure. As expected laboratory findings involve elevation of serum creatine kinase (CK), myoglobinuria, and electrolyte disturbances. Electromyogram shows fibrillations and myopathic changes, and biopsy usually shows muscle fiber necrosis.

Treatment is supportive.

#ETOH

#musculo-skeletal

References:

1. Martin F, Ward K, Slavin G, et al. Alcoholic skeletal myopathy, a clinical and pathological study. Q J Med 1985; 55:233.

2. Rubin E. Alcoholic myopathy in heart and skeletal muscle. N Engl J Med 1979; 301:28.

3. Weber LD, Nashel DJ, Mellow MH. Pharyngeal dysphagia in alcoholic myopathy. Ann Intern Med 1981; 95:189.