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Reversible Ipecac Myopathy

Reversible Ipecac Myopathy Abstract • The abuse of ipecac syrup for three years resulted in painless, nonfatigable, chiefly proximal weakness in a 27-year-old woman. Electromyography (EMG) and a muscle biopsy revealed features of a myopathy similar to those previously reported in experimental emetine myopathy. Clinical weakness and EMG abnormalities improved after discontinuation of ipecac administration. A direct toxic action of ipecac (acting through its active alkaloid, emetine hydrochloride) on muscle fibers seemed to be responsible for the weakness in this patient. References 1. Syrup of ipecac . FDA Drug Bull 1979;9:3. 2. Rollo IM: Drugs used in chemotherapy of helminthiasis , in Gilman AG, Goodman LS, Gilman A, (eds): The Pharmacological Basis of Therapeutics , ed 6. New York, Macmillan Publishing Co Inc, 1980, pp 1065-1066. 3. Nathan PE, Lipscomb TR: Behavior therapy and behavior modification in the treatment of alcoholism , in Mendelson JH, Mello NK (eds): The Diagnosis and Treatment of Alcoholism . New York, McGraw-Hill Book Co, 1979, pp 323-326. 4. Klatskin G, Friedman H: Emetine toxicity in man: Studies on the nature of early toxic manifestations, their relation to the dose level and their significance in determining safe dosage . Ann Intern Med 1948;28:892-915.Crossref 5. Lane JM, Mastaglia FM: Drug-induced myopathies in man . Lancet 1978;2:562-566.Crossref 6. Duane DD, Engel AG: Emetine myopathy . Neurology 1970;20:733-739.Crossref 7. Bradley WG, Fewings JD, Harris JB, et al: Emetine myopathy in the rat . Br J Pharmacol 1976;57:29-41.Crossref 8. Bindoff L, Cullen MJ: Experimental (-) emetine myopathy . J Neurol Sci 1978;39:1-15.Crossref 9. Fewings JD, Burns RJ, Kakulas BA: A case of acute emetine myopathy, in Kakulas BA (ed): Proceedings of the Second International Congress on Muscle Diseases: II. Clinical Studies in Myology, international congress series No. 295. Amsterdam, Excerpta Medica, 1973, pp 594-598. 10. Bennett HS, Spiro AJ, Pollack MA, Zucker P, et al: Ipecac induced myopathy simulating dermatomyositis . Neurology 1982;32:91-94.Crossref 11. Salako LA: Effects of emetine on neuromuscular transmission . Eur J Pharmacol 1970; 11:342-348.Crossref 12. MacDonald RD, Engel AG: The cytoplasmic body: Another structural abnormality of the Z disc . Acta Neuropathol 1969;14:99-107.Crossref 13. Fukuhara N, Hoshi M, Mori S: Core/targetoid fibers and multiple cytoplasmic bodies in organophosphate neuropathy . Acta Neuropathol 1977;40:137-144.Crossref 14. Dubowitz V, Brooke MH: Muscle Biopsy: A Modern Approach . London, WB Saunders Co, 1973, p 98. 15. Whisnant JP, Espinosa RE, Kierland RR, et al: Chloroquine neuromyopathy . Mayo Clin Proc 1963;38:501-513. 16. Sugie H, Russin R, Verity MA: Emetine myopathy: Two case reports with pathobiochemical analysis . Muscle Nerve 1984;7:54-59.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Reversible Ipecac Myopathy

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References (16)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1985.04060020106024
Publisher site
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Abstract

Abstract • The abuse of ipecac syrup for three years resulted in painless, nonfatigable, chiefly proximal weakness in a 27-year-old woman. Electromyography (EMG) and a muscle biopsy revealed features of a myopathy similar to those previously reported in experimental emetine myopathy. Clinical weakness and EMG abnormalities improved after discontinuation of ipecac administration. A direct toxic action of ipecac (acting through its active alkaloid, emetine hydrochloride) on muscle fibers seemed to be responsible for the weakness in this patient. References 1. Syrup of ipecac . FDA Drug Bull 1979;9:3. 2. Rollo IM: Drugs used in chemotherapy of helminthiasis , in Gilman AG, Goodman LS, Gilman A, (eds): The Pharmacological Basis of Therapeutics , ed 6. New York, Macmillan Publishing Co Inc, 1980, pp 1065-1066. 3. Nathan PE, Lipscomb TR: Behavior therapy and behavior modification in the treatment of alcoholism , in Mendelson JH, Mello NK (eds): The Diagnosis and Treatment of Alcoholism . New York, McGraw-Hill Book Co, 1979, pp 323-326. 4. Klatskin G, Friedman H: Emetine toxicity in man: Studies on the nature of early toxic manifestations, their relation to the dose level and their significance in determining safe dosage . Ann Intern Med 1948;28:892-915.Crossref 5. Lane JM, Mastaglia FM: Drug-induced myopathies in man . Lancet 1978;2:562-566.Crossref 6. Duane DD, Engel AG: Emetine myopathy . Neurology 1970;20:733-739.Crossref 7. Bradley WG, Fewings JD, Harris JB, et al: Emetine myopathy in the rat . Br J Pharmacol 1976;57:29-41.Crossref 8. Bindoff L, Cullen MJ: Experimental (-) emetine myopathy . J Neurol Sci 1978;39:1-15.Crossref 9. Fewings JD, Burns RJ, Kakulas BA: A case of acute emetine myopathy, in Kakulas BA (ed): Proceedings of the Second International Congress on Muscle Diseases: II. Clinical Studies in Myology, international congress series No. 295. Amsterdam, Excerpta Medica, 1973, pp 594-598. 10. Bennett HS, Spiro AJ, Pollack MA, Zucker P, et al: Ipecac induced myopathy simulating dermatomyositis . Neurology 1982;32:91-94.Crossref 11. Salako LA: Effects of emetine on neuromuscular transmission . Eur J Pharmacol 1970; 11:342-348.Crossref 12. MacDonald RD, Engel AG: The cytoplasmic body: Another structural abnormality of the Z disc . Acta Neuropathol 1969;14:99-107.Crossref 13. Fukuhara N, Hoshi M, Mori S: Core/targetoid fibers and multiple cytoplasmic bodies in organophosphate neuropathy . Acta Neuropathol 1977;40:137-144.Crossref 14. Dubowitz V, Brooke MH: Muscle Biopsy: A Modern Approach . London, WB Saunders Co, 1973, p 98. 15. Whisnant JP, Espinosa RE, Kierland RR, et al: Chloroquine neuromyopathy . Mayo Clin Proc 1963;38:501-513. 16. Sugie H, Russin R, Verity MA: Emetine myopathy: Two case reports with pathobiochemical analysis . Muscle Nerve 1984;7:54-59.Crossref

Journal

Archives of Neurology – American Medical Association

Published: Feb 1, 1985

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