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Alcoholic Myopathy

Myopathic Syndrome Alcoholic

Alcoholic myopathy (AM) affects one-third to more than half of alcohol abusers. It is relieved by withdrawal from alcohol consumption and exacerbated by continued misuse. In acute stages, myopathy presents as rhabdomyolysis. Alcoholic myopathy usually refers to the chronic form and mainly affects the skeletal muscle.


Presentation

Acute high dose intake of alcohol may lead to rhabdomyolysis. Most literature, when describing alcoholic myopathy (AM) suggests the chronic condition, that is precipitated by chronic alcohol abuse and is characterized by varying degrees of muscle weakness and atrophy, prominent in proximal muscle groups. It is a common cause of myopathy [1].

AM is progressive, and its severity is determined by the amount of alcohol consumed, as well as the duration of abuse [2] [3]. Furthermore, those who suffer from liver cirrhosis are more prone to the ailment [4]. In Western countries, it is thought to be the most widely encountered type of myopathy [5] [1]. Although abstinence is advised, some muscle dysfunction is permanent, thus the theory that there are multiple factors at play in the pathogenesis, such as nutrient deficiency, particularly vitamin B [6] [7] [8] is also suggested. The presence of the latter makes the clinical picture more obscure and impedes the treatment.

Acute myopathy may result in death due to renal failure and electrolyte imbalance. Rhabdomyolysis may be seen in more severe cases, while milder cases may witness a rise in creatinine kinase. Necrosis of muscle tissue, as well as weakness and pain, are also recognized.

Chronic AM has a more insidious onset, symptoms include gait disturbances, muscle weakness, and wasting. Recovery is slower than in the acute form. Muscle pain may or may not be present, moreover, neuropathy can occur simultaneously but should be treated as a separate medical entity.

Diplopia
Blurred Vision
  • This results in double and blurred vision, slurring of speech, loss of consciousness and inability to judge distances. 4. Effect on Cardio Vascular System (CVS): (i) Small doses dilate the blood vessels of skin (specially of the face) and stomach.[yourarticlelibrary.com]
Myopathy
  • Alcoholic myopathy (AM) affects one-third to more than half of alcohol abusers. It is relieved by withdrawal from alcohol consumption and exacerbated by continued misuse. In acute stages, myopathy presents as rhabdomyolysis.[symptoma.com]
  • To determine the significance of type II fiber atrophy in alcoholic myopathy and its relationship with ethanol-related diseases a prospective study was carried out in 100 chronic alcoholics who showed clinical suspicion of skeletal myopathy.[ncbi.nlm.nih.gov]
  • Of the CAM patients, 24 (55%) presented clinical symptoms of myopathy, whereas proximal muscle atrophy was observed in 15 patients (35%).[ncbi.nlm.nih.gov]
  • Chronic myopathy is a common complication of alcoholism, but its natural history has not been well described.[ncbi.nlm.nih.gov]
  • ., myopathy) is common in patients with alcohol use disorder. However, few clinical studies have elucidated the significance, mechanisms, and therapeutic options of alcohol-related myopathy.[ncbi.nlm.nih.gov]

Workup

Diagnosis is made by combining the clinical picture, histological and laboratory findings. Muscle atrophy as a result of impaired synthesis as well as apoptosis may be evaluated microscopically, and type II fibers are most affected [1] [3]. Type I muscle fibers are usually normal [9].

In high magnification studies, acute alcohol intake also produces histological evidence of cell injury where damage to cell organelles such as the mitochondria, sarcoplasmic reticulum is visualized, together with the failure of fat and glycogen storage regulatory mechanisms and cell edema. The histological picture is similar to that of alcoholic liver disease [10]. Further tests, conducted routinely when presented with a patient suffering from a myopathy, include:

  • Laboratory tests: Mostly, these comprise of measuring serum levels of creatinine kinase, myoglobin, creatinine, urea, aspartate aminotransferase (AST) as well as determining the erythrocyte sedimentation rate (ESR). Full blood count and thyroid function tests may also be advised.
  • Urinalysis: This is carried out to demonstrate myoglobinuria, which is a positive finding in alcoholic myopathy.
  • Electrocardiogram (ECG) tracings may be requested and may show signs of hyperkalemia such as wide QRS complexes, lengthened PR intervals and other wave changes.
Aldolase Increased
  • Diagnosis Identification of Alcohol Toxic Pathogenesis According to the history of drinking, the typical clinical symptoms, signs, serum CPK, aldolase increased, the diagnosis of acute myopathy is not difficult, the determination of serum enzyme levels[healthfrom.com]

Treatment

  • Treatment Treatment of alcoholic myopathy Department of Internal Medicine: Department of Internal Medicine Treatment: drug treatment supportive treatment Treatment cycle: 3 months Cure rate: 40% Commonly used drugs: naloxone hydrochloride sublingual tablets[healthfrom.com]
  • Providing broader coverage of the subject than any available monograph, the editors and their panel of experts relate basic science to pathogenesis and treatment modalities and explore future developments.[books.google.de]
  • Treatment includes quitting drinking. Quitting drinking often results in improved heart function. Continued alcohol consumption, on the other hand, will continue to make alcoholic cardiomyopathy worse.[northshore.org]
  • Discussions around the web We found 8 discussions Treato does not review third-party posts for accuracy of any kind, including for medical diagnosis or treatments, or events in general. Treato does not provide medical advice, diagnosis or treatment.[treato.com]
  • The presence of the latter makes the clinical picture more obscure and impedes the treatment. Acute myopathy may result in death due to renal failure and electrolyte imbalance.[symptoma.com]

Prognosis

  • (B) prognosis Acute myopathy is generally a few days to several weeks after drinking can be restored, chronic myopathy often associated with peripheral neuropathy, the prognosis and chronic alcoholism related.[healthfrom.com]
  • Prognosis This depends on the specific diagnosis. The primary disorders are incurable conditions with varied prognosis. Secondary myopathy may be corrected by treating the underlying cause.[patient.info]
  • No randomized controlled study examined the effect of alcoholism on ICU prognosis [ 12 ].[ccforum.biomedcentral.com]
  • Recognition is extremely important as most of these are reversible when diagnosed and managed in a timely fashion and thus carry a good prognosis.[frontiersin.org]
  • Prognosis Complete recovery from Wernicke's syndrome may follow prompt administration of thiamine. However, repeated episodes of encephalopathy or prolonged alcohol abuse may cause persistent dementia or Korsakoff psychosis .[medical-dictionary.thefreedictionary.com]

Etiology

  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • […] and cirrhosis Ethanol metabolism and its consequences Mechanisms in the pathogenesis of ALD, including genetics, immunology, and insulin-like growth factors Extrahepatic effects of ALD and the role of alcohol in potentiating liver damage due to other etiologies[books.google.de]
  • Etiology Alcoholic Toxic Pathology (A) the cause of the disease Many patients with long history of drinking history, alcoholism myopathy and alcohol toxicity is closely related, but its pathogenesis is unclear.[healthfrom.com]
  • These conditions have widely varying etiologies, including congenital or inherited, idiopathic, infectious, metabolic, inflammatory, endocrine, and drug-induced or toxic.[emedicine.medscape.com]
  • Clues to these other etiologies are often apparent in the history.[clinicaladvisor.com]

Epidemiology

  • This review details the epidemiology of alcoholic myopathy, potential contributing pathophysiologic mechanisms, and emerging literature on novel therapeutic options.[ncbi.nlm.nih.gov]
  • Mechanisms in the pathogenesis of ALD, including genetics, immunology, and insulin-like growth factors Extrahepatic effects of ALD and the role of alcohol in potentiating liver damage due to other etiologies Interaction of alcohol with viral hepatitis Epidemiology[books.google.de]
  • Neurologic Consequences of Malnutrition begins with an overview of the epidemiology and incidence of malnutrition and neurologic disorders.[books.google.de]
  • EPIDEMIOLOGY One third of heavy long-term alcohol consumption (of any beverage type), aka alcoholics, in both sexes and all races, develop skeletal myopathy.[flipper.diff.org]
Sex distribution
Age distribution

Pathophysiology

  • This review details the epidemiology of alcoholic myopathy, potential contributing pathophysiologic mechanisms, and emerging literature on novel therapeutic options.[ncbi.nlm.nih.gov]
  • Methods: We reviewed the literature on alcoholic myopathy and hypovitaminosis D myopathy and compared the pathophysiological findings to designate possible mechanisms of vitamin D action in alcohol-related myopathy.[research.vu.nl]
  • The Gale Encyclopedia of Public Health states, 2002 - Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology, Piano MR., 2002 SYMPTOMS Alcoholic myopathy can have serious symptoms and side effects.[flipper.diff.org]
  • Muskiet, a professor of pathophysiology and clinical chemical analysis at the University Medical Center Groningen.[sciencedaily.com]
  • Muskiet, a professor of pathophysiology and clinical qualitative analysis on the University Medical Center Groningen.[medimoon.com]

Prevention

  • Increasing dietary potassium raised serum potassium but did not prevent EAM.[ncbi.nlm.nih.gov]
  • However, alpha-tocopherol supplementation has failed to prevent either the loss of skeletal muscle protein or the reductions in protein synthesis in alcohol-dosed animals.[ncbi.nlm.nih.gov]
  • We also unexpectedly found that, in some alcoholics, a substantial reduction in the amount of alcohol consumed may be as effective as complete abstinence in improving muscle strength or preventing its deterioration.[ncbi.nlm.nih.gov]
  • Alcohol and metabolites Acetaldehyde toxic effects on muscle cells, the muscle sheath and mitochondria are damaged, mitochondrial dysfunction, or to prevent actin and myoglobin kinase, to prevent troponin binding, and thus damage Cell structure, affecting[healthfrom.com]

References

Article

  1. Preedy VR, Adachi J, Ueno Y, et al. Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis. Eur J Neurol. 2001;8(6):677–687.
  2. Sacanella E, Fernandez-Sola J, Cofan M, et al. Chronic alcoholic myopathy: diagnostic clues and relationship with other ethanol-related diseases. QJM. 1995;88(11):811–817.
  3. Fernández-Solà J, Nicolás JM, Fatjó F, et al. Evidence of apoptosis in chronic alcoholic skeletal myopathy. Hum Pathol. 2003;34(12):1247–1252.
  4. Preedy VR, Ohlendieck K, Adachi J, et al. The importance of alcohol-induced muscle disease. J Muscle Res Cell Motil. 2003;24(1):55–63.
  5. Adachi J, Asano M, Ueno Y, et al. Alcoholic muscle disease and biomembrane perturbations (review). J Nutr Biochem. 2003;14(11):616–625.
  6. Estruch R, Sacanella E, Fernandez-Sola J, Nicolas JM, Rubin E, Urbano-Marquez A. Natural history of alcoholic myopathy: a 5-year study. Alcohol Clin Exp Res. 1998;22(9):2023–2028.
  7. Fernandez-Sola J, Sacanella E, Estruch R, Nicolas JM, Grau JM, Urbano-Marquez A. Significance of type II fiber atrophy in chronic alcoholic myopathy. J Neurol Sci. 1995;130(1):69–76.
  8. Nicolas JM, Garcia G, Fatjo F, et al. Influence of nutritional status on alcoholic myopathy. Am J Clin Nutr. 2003;78(2):326–333.
  9. Preedy VR, Crabb DW, Farres J, Emery PW. Alcoholic myopathy and acetaldehyde. Novartis Found Symp. 2007;285:158–177 (discussion 177–182, 198–159).
  10. Del Villar Negro A, Merino Angulo J, Rivera-Pomar JM. Skeletal muscle changes in chronic alcoholic patients. A conventional, histochemical, ultrastructural and morphometric study. Acta Neurol Scand. 1984;70(3):185–196.

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Last updated: 2018-06-22 06:11