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NEUROLOGY 1975;25:405
© 1975 American Academy of Neurology

Tubular aggregates in subclinical alcoholic myopathy

LUIS A. CHUI, M.D., HARRY NEUSTEIN, M.D. and THEODORE L. MUNSAT, M.D.

Neuromuscular Unit, Department of Neurology, Los Angeles County-University of Southern California Medical Center, and the Department of Pathology, Los Angeles Childrens' Hospital, Los Angeles.

A 34-year-old chronic alcoholic with acute alcoholic intoxication was found to have extensive aggregates on muscle biopsy performed 48 hours after admission. Forearm ischemic exercise failed to demonstrate normal generation of lactic acid. Pathologic changes in the muscle biopsy consisted of subsarcolemmal accumulations of bright purple-red material with trichrome reaction. This material stained darkly with NADH-TR but was unstained with myofibrillar ATPase and PAS. Ultrastructural studies revealed that these regions contained tubular aggregates. A second biopsy 7 days later failed to demonstrate any significant abnormalities. Two weeks later, lactate generation was normal. Previous observations by other authors that tubular aggregates may be concerned with correction of metabolic defect or detoxification of endogenous toxins could apply in our case.

Supported in part by grants from the Muscular Dystrophy Association of America, USPHS General Clinical Research Center grant RR-43, USPHS grant R01-AA0338-01, and Michael J. Connel Foundation, L.A.

Received for publication August 16, 1974.

Reprint requests should be addressed to Dr. Chui at Neuromuscular Unit, Department of Neurology, LAC/USC Medical Center, 1200 N. State Street, Los Angeles, CA 90033.




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