Autonomic neuropathy in patients with hepatic cirrhosis
| Autor: | B K Bajaj, B Krishna Ram, Manisha Agarwal |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Liver Cirrhosis
Alcoholic liver disease medicine.medical_specialty Pathology Cirrhosis Posture Blood Pressure Gastroenterology Liver disease Heart Rate Internal medicine Heart rate medicine Humans In patient business.industry Respiration Case-control study General Medicine medicine.disease Blood pressure Peripheral neuropathy Autonomic Nervous System Diseases Case-Control Studies Original Article business |
| Zdroj: | Postgraduate Medical Journal. 79:408-411 |
| ISSN: | 1469-0756 0032-5473 |
| DOI: | 10.1136/pmj.79.933.408 |
| Popis: | Background Autonomic neuropathy has been reported in patients with alcoholic liver disease but information on its occurrence in patients with non-alcoholic liver disease is contradictory. Aim To assess autonomic functions in patients with alcoholic and non-alcoholic liver disease. Study design Autonomic function using five standard tests was examined in 20 cirrhotics (10 alcoholics and 10 non-alcoholics) and 20 age and sex matched controls. The extent of autonomic dysfunction was determined in the patients and a comparison between the characteristics of patients with and without autonomic neuropathy was made. Results Sixteen (80%) of the cirrhotic subjects were found to have evidence of autonomic neuropathy. Of these, three (15%) patients had early parasympathetic damage, five (25%) had definite parasympathetic damage, and eight (40%) had combined (that is, both parasympathetic and sympathetic) damage. Nine (90%) of the alcoholics and seven (70%) of the non-alcoholics had autonomic dysfunction. Only one patient belonging to the alcoholic group had clinical evidence of peripheral neuropathy. Moreover, there was no significant association between subjective symptoms of autonomic neuropathy and objective evidence of autonomic damage as assessed by autonomic function tests. Autonomic dysfunction was significantly more frequent in advanced liver disease compared with early liver damage. Nine (75%) out of 12 cirrhotic subjects belonging to Child class B and six (85.7%) of the seven patients belonging to Child class C had autonomic neuropathy. Conclusion This study shows that autonomic neuropathy is common in cirrhotic subjects, that it is found with comparable frequency in alcoholics and non-alcoholics, and that it increases in severity with increase in extent of liver damage, suggesting that liver damage contributes to the neurological deficit. |
| Databáze: | OpenAIRE |
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