Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis

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Abstract

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 ± 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). 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.

Original languageEnglish
Pages (from-to)1019-1025
Number of pages7
JournalThe American Journal of Medicine
Volume125
Issue number10
DOIs
StatePublished - Oct 2012

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Muscle Cramp
Fibrosis
Morbidity
Liver Diseases
Chronic Disease
Vitamin D
Vitamin D Deficiency
Hepatic Encephalopathy
Pain Measurement
Informed Consent
Serum Albumin
Cohort Studies
Quality of Life
Surveys and Questionnaires

Keywords

  • Chronic liver disease questionnaire
  • Cirrhosis
  • Muscle cramps

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{0091b440d2714fb4a187aa416f70043d,
title = "Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis",
abstract = "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 ± 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). 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.",
keywords = "Chronic liver disease questionnaire, Cirrhosis, Muscle cramps",
author = "Hemant Chatrath and Suthat Liangpunsakul and Marwan Ghabril and Julie Otte and Naga Chalasani and Raj Vuppalanchi",
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language = "English",
volume = "125",
pages = "1019--1025",
journal = "American Journal of Medicine",
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T1 - Prevalence and Morbidity Associated with Muscle Cramps in Patients with Cirrhosis

AU - Chatrath, Hemant

AU - Liangpunsakul, Suthat

AU - Ghabril, Marwan

AU - Otte, Julie

AU - Chalasani, Naga

AU - Vuppalanchi, Raj

PY - 2012/10

Y1 - 2012/10

N2 - 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 ± 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). 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.

AB - 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 ± 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). 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.

KW - Chronic liver disease questionnaire

KW - Cirrhosis

KW - Muscle cramps

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