Acute fatal alcoholic myopathy with rhabdomyolysis has been reported with history of a heavy bout of drinking, or a withdrawal after a sustained period of heavy drinking. We report an acute fatal myopathy after long abstinence of alcohol.

A 69-year-old woman had been drinking for 30 years and was diagnosed with alcoholic liver cirrhosis. After the diagnosis was made, she ceased drinking. She developed ascites 2 months later and became progressively worse requiring hospitalization. She developed severe myalgia and proximal weakness 20 days after hospitalization. The serum levels of lactate dehydrogenase, creatine phosphokinase, aspartate aminotransferase after the onset of weakness were 676, 9132 (MM type: 82.6%), and 886 IU/L, respectively. The serum myoglobin level was more than 300 mg/dl. The muscle scintigraphic study with technetium-99 monophosphate showed increased radionuclide uptake in proximal muscles of both upper and lower extremities. Nerve conduction and needle EMG studies were performed. She died on the 4th day of onset of weakness because of rhabdomyolysis induced acute renal failure. Even though, we couldn't perform the muscle biopsy, the clinical course and all the findings were compatible with acute alcoholic myopathy associated with polyneuropathy.