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Experimental emetine myopathy: enzyme histochemical, electron microscopic, and immunomorphological studies

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Summary

Ipecac, containing emetine hydrochloride, is used by patients with anorexia nervosa to induce vomiting. Its chronic usage may result in a myopathy and a cardiomyopathy, the former marked by cytoplasmic bodies. We studied myopathological changes after daily injections of female Wistar rats with emetine hydrochloride intraperitoneally for periods of 4, 5, 9, and 10 weeks. the extensor digitorum longus muscle and the soleus muscle showed core-like lesions, streaming of the z-discs, nemaline bodies, cytoplasmic bodies, and spheroid cytoplasmic bodies. Immunomorphological studies revealed increased amounts of desmin. During a period of repair, i.e., 2, 4, and 6 weeks after termination of emetine application, these myopathological alterations faded while proliferation of the T-tubular system, i.e., honeycomb structures, was more often prevalent. Pathological features completely disappeared between 6 and 12 weeks of recovery.

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References

  1. Adler AG, Walinsky P, Krall RA, Cho SY (1980) Death resulting from ipecac syrup poisoning. JAMA 243: 1927–1928

    Google Scholar 

  2. Beller BM (1968) Observations on the mechanism of emetine poisoning of myocardial tissue. Circ Res 22:501–505

    Google Scholar 

  3. Bethlem J, Arts WF, Dingemans KP (1978) Common origin of rods, cores, miniature cores, and focal loss of cross striations. Arch Neurol 35:555–566

    Google Scholar 

  4. Bindoff L, Cullen MJ (1978) Experimental emetine myopathy. J Neurol Sci 39:1–15

    Google Scholar 

  5. Bradlcy WG, Fewings JD, Johnson MA (1976) Emetine myopathy in the rat. Br J Pharmacol 57:29–41

    Google Scholar 

  6. Brem TH, Konwaler BE (1955) Fatal myocarditis due to emetine hydrochloride. Am Heart J 50:476–481

    Google Scholar 

  7. Chou SM, Mizuno Y (1986) Induction of spheroid cytoplasmic bodies in a rat muscle by local tetanus. Muscle Nerve 9:455–464

    Google Scholar 

  8. Cullen MJ, Fulthorpe JJ, Harris JB (1992) The distribution of desmin and titin in normal and dystrophic human muscle. Acta Neuropathol 83:158–169

    Google Scholar 

  9. Duane DD, Engel AG (1970) Emetine myopathy. Neurology 8:733–739

    Google Scholar 

  10. Edström L, Thornell LE, Eriksson A (1980) A new type of hereditary distal myopathy with characteristic sarcoplasmic bodies and intermediate (skeletin) filaments. J Neurol Sci 47:171–190

    Google Scholar 

  11. Forth W, Henschler D, Rummel W (1983) Pharmakologie und Toxikologie, 4th edn. Wissenschaftsverlag, Zürich

    Google Scholar 

  12. Friedmann EJ (1984) Death from ipecac intoxication in a patient with anorexia nervosa. Am J Psychiatry 141:702–703

    Google Scholar 

  13. Goebel HH (1986) Neuropathological aspects of congenital myopathies. Prog Neuropathol 6:231–262

    Google Scholar 

  14. Halbig L, Gutmann L, Goebel HH, Brick JF, Schochet S (1988) Ultrastructural pathology in emetine induced myopathy. Acta Neuropathol (Berl) 75:577–582

    Google Scholar 

  15. Halmi KA, Falk JR, Schwartz E (1981) Binge eating and vomiting; a survey of a college population. Psychol Med 11:697–706

    Google Scholar 

  16. Kuntzer T, Bogousslavsky J, Deruaz JP, Janzer R, Regli F (1989) Reversible emetine induced myopathy with ECG abnormalities: a toxic myopathy. J Neurol 236:246–248

    Google Scholar 

  17. Lietman PS (1971) Mitochondrial protein synthesis: inhibition by emetine hydrochloride. Mol Pharmacol 7:122–128

    Google Scholar 

  18. Mateer JE, Farrell BJ, Chou SM, Gutmann L (1985) Reversible ipecac myopathy. Arch Neurol 42:188–190

    Google Scholar 

  19. Osborn M, Goebel HH (1983) The cytoplasmic bodies in a congenital myopathy can be stained with antibodies to desmin, the muscle-specific intermediate filament protein. Acta Neuropathol (Berl) 62:149–152

    Google Scholar 

  20. Palmer EP, Guay AT (1985) Reversible myopathy secondary to abuse of ipecac in patients with major eating disorders. N Engl J Med 313:1457–1459

    Google Scholar 

  21. Schiff RJ, Wurzel CL, Brunson SC, Kasloff I, Nussbaum MP, Frank SD (1986) Death due to chronic syrup of ipecac use in a patient with bulimia. Pediatrics 78:412–416

    Google Scholar 

  22. Schröder JM, Sommer C, Schmidt B (1990) Desmin and actin associated with cytoplasmic bodies in skeletal muscle fibers: immunocytochemical and fine structural studies, with a note on unusual 18-to 20-nm filaments. Acta Neuropathol 80:406–414

    Google Scholar 

  23. Sugie H, Russin R, Verity MA (1984) Emetine myopathy: two case reports with pathobiochemical analysis. Muscle Nerve 7:54–59

    Google Scholar 

  24. Thornell LE, Edström L, Eriksson A, Henriksson KG, Ängovist KA (1980) The distribution of intermediate filament protein (skeletin) in normal and diseased human skeletal muscle. J Neurol Sci 47:153–170

    Google Scholar 

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Hopf, N.J., Goebel, H.H. Experimental emetine myopathy: enzyme histochemical, electron microscopic, and immunomorphological studies. Acta Neuropathol 85, 414–418 (1993). https://doi.org/10.1007/BF00334453

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  • DOI: https://doi.org/10.1007/BF00334453

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