Serum and urinary myoglobin in alcoholics.

The serum levels of myoglobin were measured in 106 male alcoholics. Subnormal levels were found in 31% of the alcoholics with no alcohol consumption for the last 2--4 weeks, while none of them had elevated levels. Of the alcoholics on ambulatory control and with varying current alcohol intake. 18% had increased levels compared to healthy controls. Serial myoglobin levels were determined in 19 patients following the cessation of heavy drinking sprees. Despite the fact that none of the patients had clinical evidence of acute myopathy, marked myoglobin elevations were noted in five patients; their serum levels gradually declined and normalized with 4--7 days. Comparing the three groups, similar frequencies of subnormal or elevated serum CK levels were observed. Myoglobin levels were not raised due to impaired glomerular filtration rates. No correlation was found between serum myoglobin and laboratory signs of liver affection. Although hypophosphatemia, hypomagnesemia and hypokalemia were occasionally noted, decreased serum electrolytes did not have any relation to elevated serum myoglobin. A transient, slightly increased urinary excretion of myoglobin parallel with increased excretion of beta 2-microglobulin was observed in 2/17 alcoholics, suggesting that instances of myoglobinuria in alcoholics with heavy recent drinking may be due to a transient minor tubular dysfunction.