Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis

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• 作者：Hemant Chatrath ; Suthat Liangpunsakul ; Marwan Ghabril ; Julie Otte ; Naga Chalasani ; Raj Vuppalanchi
• 关键词：Chronic liver disease questionnaire ; Cirrhosis ; Muscle cramps
• 刊名：The American Journal of Medicine
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：125
• 期：10
• 页码：1019-1025
• 全文大小：838 K

文摘

Purpose

Patients with cirrhosis often experience muscle cramps with varying severity. We investigated the factors associated with the prevalence and morbidity associated with muscle cramps.

Methods

A total of 150 adult patients with cirrhosis were enrolled consecutively. Cramp questionnaire with visual analogue scale for pain, Chronic Liver Disease Questionnaire (CLDQ), and blood for measurement of 25-(OH) vitamin D levels were obtained after informed consent.

Results

A total of 101 patients (67 % ) reported muscle cramps in the preceding 3 months. Patients with cramps had significantly lower serum albumin (3.1 ¡À 0.6 g/dL vs 3.3 ¡À 0.7 g/dL, P = .04) and CLDQ scores (107 ¡À 37 vs 137 ¡À 34, P <.0001) compared with those without cramps. The median composite symptom score, defined as product of frequency and severity of cramps, in the study cohort was 12 with a range of 0.3 to 200. There were no clinical or biochemical predictors for occurrence of any cramps or severe cramps (composite symptom score > 12). Muscle cramps (P <.001) and hepatic encephalopathy (P = .009) were associated independently with decreased CLDQ scores. Vitamin D deficiency was seen in 66 % of the study cohort, but the serum 25-(OH) vitamin D levels were not significantly different between patients with and without cramps (18.0 ¡À 8.9 ng/mL vs 19.6 ¡À 9.5 ng/mL, P = .49).

Conclusions

Muscle cramps are associated with significantly diminished quality of life in patients with cirrhosis. More research is needed to better understand their mechanism to develop effective treatment.