Emetine myopathy: two case reports with pathobiochemical analysis.
We report two female patients with a history of alcohol abuse presenting with proximal painful muscle weakness following aversion therapy with emetine hydrochloride. Muscle biopsy of Case 1 showed a reversible floccular-shaped loss of myosin ATPase and dehydrogenase, an accumulation of PAS positive material, and a normal lipid content. Repeat biopsy showed core change with no focal loss of myosin ATPase. In Case 2, muscle biopsy was taken 1 month after commencement of emetine therapy and revealed similar but milder changes to Case 1. Electron microscopy revealed Z-band streaming with a decrease or loss of mitochondria. Sarcotubular systems appeared normal in shape and size. Anaerobic glycolysis on homogenate from the initial biopsy of Case 1 showed generalized reduction of lactate formation, which returned to normal in the repeat biopsy.
D000427:Alcohol Deterrents / Q000009:adverse effects*; D004640:Emetine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008854:Microscopy, Electron; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D009135:Muscular Diseases / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology
D000427:Alcohol Deterrents; D004640:Emetine