Autonomic Dysfunction In Cirrhosis Of Liver-A One Year Cross Sectional Study

Abstract

BACKGROUND AND OBJECTIVES Cirrhosis is a chronic disease of the liver of various aetiology that leads to a number of complications,some of which may eventually prove fatal. Over the years, some studies have reported that patients with chronic liver disease who have associated autonomic neuropathy respond inappropriately or defectively to major events such as septicemia and variceal haemorrhage. The quality of life in these patients is impaired and the risk of sudden cardiac death in these patients is high. Studies on the above given topic are few and hence study is undertaken and to know the prevalence of autonomic dysfunction which helps in effective treatment of the disease. METHODOLOGY The present one year cross-sectional study was done in the Department of General Medicine at KLES Dr Prabhakar kore Hospital and Medical Research Centre Belagavi. A total of 100 patients were included in the study. Patients were subjected to clinical examination, laboratory workup like complete blood count, liver function test, electrocardiogram, ultrasound abdomen and autonomic functions were assessed with help of electrocardiogram, and presence of dysautonomia in these patients was assessed based on the test results. RESULTS Majority of the patients had evidence of dysautonomia ie 83 patients.There were more cases of dysautonomia in age group of 41-60 years.In our study there were 95% males and 5% females. Clinical presentation of dysautonomia was dizziness and impotence. Majority of patients had early dysautonomia rather than definite dysautonomia.Evidence of dysautonomia was more common with cirrhosis secondary to HBV,HCV as compared to alcoholics. CONCLUSION AND INTERPRETATION Autonomic dysfunction was seen in majority of our patients.In patients with aetiology like HBV, HVC, autoimmune, had more autonomic dysfunction as compared to alcohol related cirrhosis of liver. There is strong evidence of dysautonomia in majority of patients with various aetiology.The evidence of dysautonomia was more observed with patient with increasing age.