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Clinical Notes
October 12, 1979

Alcoholic MyopathyDiagnosis by Alcohol Challenge

Author Affiliations

From the Division of Clinical Pharmacology, Departments of Internal Medicine (Drs Spector, Choudhury, and Lakin) and Pathology (Dr Cancilla), University of Iowa College of Medicine, Iowa City.

JAMA. 1979;242(15):1648-1649. doi:10.1001/jama.1979.03300150046027

MANY agents, including drugs and alcohol, can cause rhabdomyopathy.1 Alcoholic myopathy may have a varied presentation and is classified as acute, subacute, or chronic.2-6 Acute or subacute alcoholic myopathy is related to the ingestion of excessive amounts of alcohol and generally characterized by diffuse or focal tenderness and muscle cramps.2-6 The serum creatinine phosphokinase (CPK) activity is elevated, and muscle biopsy specimens frequently show a nonspecific pattern with degeneration and regeneration of muscle fibers.2-7 Chronic alcoholic myopathy is characterized by proximal muscle weakness with minimal, nonspecific changes on muscle biopsy specimens.2,3,5 Even in healthy volunteers receiving a nutritious diet supplemented with vitamins, 225 g of alcohol ingested daily for three weeks caused slight elevations in serum CPK activity and minimal but definite abnormalities on muscle biopsy specimens.8

We present a case of a young man with a puzzling myopathy. After a lengthy examination with nonspecific findings, a diagnostic alcohol challenge disclosed