Acute myopathy associated with liver cirrhosis.
OBJECTIVE
Many cirrhotic patients have muscular symptoms and rhabdomyolysis. However, myopathy associated with liver cirrhosis has not been established as a disease entity. We evaluated the clinical significance of acute myopathy associated with liver cirrhosis.


METHODS
We retrospectively reviewed the medical records of 5440 cirrhotic patients who had been admitted to Gyeongsang National University Hospital from August 1997 to January 2003. Among these, 99 developed acute myopathies, and they were analyzed with respect to clinical and laboratory parameters, and outcomes.


RESULTS
The Child-Pugh classification at the time of myopathy onset was A in 3(3.1%) cases, B in 33(33.3%), and C in 63 (63.6%). Infection was identified as the most predisposing factor to myopathy. Fifty percent of 18 idiopathic cases who were tested for influenza antibody were positive. Forty-two of the 99 cases were complicated by acute renal failure, and 25 (59.5%) of these expired. Apart from 6 cases lost to follow-up, 64 of 93 recovered, giving a mortality rate of 31.2%. Mortality was higher in Child-Pugh class C than in B or A.


CONCLUSIONS
Acute myopathy can develop as a serious complication in liver cirrhosis. Its frequency, severity and mortality depend on underlying liver function, and are higher in decompensated liver cirrhosis. Influenza should be considered as an etiologic factor in idiopathic cases. It is proposed that acute myopathy associated with liver cirrhosis be called 'hepatic myopathy', and that careful monitoring for hepatic myopathy is necessary in the patients with advanced liver cirrhosis.
Lee
Ok-Jae
OJ
Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyongnam, 660-702, South Korea. ojlee@nongae.gsnu.ac.kr
Yoon
Jee-Hyang
JH
Lee
Eun-Jeong
EJ
Kim
Hyun-Jin
HJ
Kim
Tae-Hyo
TH
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000209:etiology*; D009211:Myoglobin / Q000097:blood; D011877:Radionuclide Imaging; D012206:Rhabdomyolysis / Q000209:etiology
D009211:Myoglobin; D007770:L-Lactate Dehydrogenase