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To the Editor:
We read with interest the article on creatine monohydrate (CM) treatment in neuromuscular disease by Tarnopolsky and Martin.1 The article reports that CM has therapeutic potential for various neuromuscular diseases. The study also suggests that creatine administration improved motor behavior and prolonged survival in the SOD (G93A) transgenic mouse, an animal model of ALS.2 We have encountered several patients with refractory polymyositis or inclusion body myositis (IBM) who did not respond to high doses of corticosteroids, other immunosuppressants, plasma exchange, and high-dose immunoglobulin therapy. Among them, CM treatment attenuated hyperCKemia but did not enhance muscle strength in one patient with IBM. We would like to present such a patient and pose several questions concerning CM administration.
A 51-year-old Japanese woman noticed muscle weakness in the lower extremities. One month later, she was no longer ambulatory and developed muscle weakness in the upper extremities. Her mother had died of malignant lymphoma and her sister has had Hashimoto thyroiditis. Neurologic examination revealed muscle weakness in the upper (Medical Research Council [MRC] 3/5) and lower (MRC 2/5) extremities, predominantly in the proximal portion. …
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