Ipecac‐induced myopathy simulating dermatomyositis

Abstract

We studied a young woman with an eating disorder. To induce vomiting, she took syrup of ipecac daily for 2 years, and then developed insidious, progressive muscle weakness. Skin findings were similar to those of dermatomyositis. Muscle biopsy, however, was similar to experimental emetine myopathy and lacked inflammatory features. Upon cessation of ipecac abuse, strength returned. We believe that this patient had ipecac-induced muscle weakness.

The eating disorders medicine cabinet revisited: A clinician's guide to ipecac and laxatives

“…1 There have been various case reports of myopathies and cardiomyopathies published. [2][3][4][5][6][7][8] Medical management of patients misusing ipecac requires discontinuation of the drug and careful evaluation for myopathy, including cardiomyopathy. If the cardiovascular system appears to be affected, an electrocardiogram and an echocardiogram should be obtained.…”

Iatrogenic and toxic myopathies

“…Ipecac abuse may result in skin changes similar to those of dermatomyositis. These skin changes may be the reason for misdiagnosis in anorectic patients 10…”

Ipecac syrup abuse, morbidity, and mortality: Isn’t it time to repeal its over-the-counter status?

“…This review of the medical literature confirms that it may result in severe morbidity and mortality [22][23][24][25][26][27][28][29][30][31][32][53][54][55][56][57][58][59][60][61][62].…”

“…Symptoms initially may be nonspecific and underreported. The prominent symptoms of chronic use are intractable vomiting, diarrhea, hemorrhagic colitis, muscular weakness, cardiac failure, and arrhythmias [55][56][57][58][59][60][61][62][63][64][65][66][67][68].Frequently users will be denying the seriousness of the symptomatology or will not see the connection between their use of ipecac and feeling sick. Some, who understand what is happening to them, may still lie about it, in their unshakable conviction that "I'd rather be dead than fat."…”