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September 8, 1978

Diagnosis of Neuropathic vs Myopathic Disease

Author Affiliations

New York Medical College New York

JAMA. 1978;240(11):1141. doi:10.1001/jama.1978.03290110039013

To the Editor.—  A CLINICAL NOTE (239:2018, 1978) concerning renal failure following intravenous pyelography describes a patient with apparent diabetic amyotrophy. The workup is described as having been undertaken "to find out the cause of his proximal amyotrophy and weight loss." Very complete laboratory investigations were carried out (including the fatal intravenous pyelogram), but the single, most important investigation necessary in any neuromuscular involvement was not done. I refer to electrodiagnostic evaluation. If the patient indeed had diabetic amyotrophy, the electrodiagnositc findings might have been of diagnostic importance.1 Certainly, there is no apparent justification to have labeled the disorder a "profound myopathy" when the involvement more probably was neuropathic in nature.