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Use of dynamic tests of muscle function & histomorphometry of quadriceps muscle biopsies in the investigation of patients with chronic alcohol misuse & Chronic Fatigue Syndrome (CFS)

  [ 99 votes ]   [ Discuss This Article ]
www.ProHealth.com • September 3, 1994


Ischaemic lactate/ammonia tests, serum carnosinase and
creatine kinase assays and percutaneous needle muscle biopsies
were performed on 10 patients with chronic fatigue syndrome
(CFS), and 10 with chronic alcohol misuse complaining of
muscular symptoms.
Basal serum lactate levels were significantly elevated in
the alcohol misusers compared to the CFS patients, but all
were within the reference range. Lactate profiles after
ischaemic forearm exercise did not differ significantly for
the two patient groups. In one patient previously diagnosed as
having CFS, myoadenylate deaminase deficiency was identified
on the basis of a flat ammonia response to ischaemia and
absent muscle adenosine monophosphate deaminase activity. In
addition, two further patients in the CFS group were
subsequently shown to have other disorders: one had
polymyositis and one had myopathy with mild type II fibre
atrophy of unknown cause. Histomorphometric examination of
muscle needle biopsy in the alcohol misusers showed features
of chronic alcohol-induced skeletal myopathy in six patients
and polymyositis in one patient. Type II fibre atrophy factors
were significantly elevated in the alcohol group but were
within the reference range in CFS patients. Dynamic tests of
muscle function and muscle histology are valuable tools in
excluding alternative pathology in CFS, whereas muscle
histomorphometry is of the greatest value in the diagnosis of
chronic alcoholic myopathy.

Wassif WS, Sherman D, Salisbury JR, Peters TJ




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