Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis |
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| Authors: | Hemant Chatrath Suthat Liangpunsakul Marwan Ghabril Julie Otte Naga Chalasani Raj Vuppalanchi |
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| Affiliation: | 1. Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind;2. Indiana University School of Nursing, Indianapolis;1. Wiwanitkit House, Bangkhae, Bangkok, Thailand;2. Hainan Medical University, Haikou, China;3. Joseph Ayobabalola University, Ikeji Arakeji, Osun State, Nigeria;1. Innsbruck Medical University, Austria;2. Universitätsklinik für Neurologie, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria;3. Innsbrucker Soziale Dienste (ISD), Austria;1. Providence Health Care & University of Washington School of Medicine, Spokane, Washington;2. Washington University, St Louis, Missouri;3. Eli Lilly & Co, Indianapolis, Indiana;4. Inventiv Health Clinical, La Jolla, California;1. Harran University, Faculty of Medicine, Department of Gastroenterology, Sanliurfa, Turkey;2. Istanbul University, Istanbul Faculty of Medicine, Department of Gastroenterohepatology, Capa 34093, Istanbul, Turkey;3. Duzce University, Faculty of Medicine, Department of Gastroenterology, Duzce, Turkey;4. Istanbul University, Istanbul Faculty of Medicine, Department of Pathology, Capa 34093, Istanbul, Turkey;5. Istanbul University, Istanbul Faculty of Medicine, Department of Microbiology, Capa 34093, Istanbul, Turkey;1. Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany;2. Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany |
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| Abstract: | PurposePatients with cirrhosis often experience muscle cramps with varying severity. We investigated the factors associated with the prevalence and morbidity associated with muscle cramps.MethodsA 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.ResultsA total of 101 patients (67%) reported muscle cramps in the preceding 3 months. Patients with cramps had significantly lower serum albumin (3.1 ± 0.6 g/dL vs 3.3 ± 0.7 g/dL, P = .04) and CLDQ scores (107 ± 37 vs 137 ± 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 ± 8.9 ng/mL vs 19.6 ± 9.5 ng/mL, P = .49).ConclusionsMuscle 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. |
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