title: Prevalence and morbidity associated with muscle cramps in patients with cirrhosis.
abstract: OBJECTIVE
  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.
authors: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors: Hemant
authors: H
authors: Chatrath
authors: Suthat
authors: S
authors: Liangpunsakul
authors: Marwan
authors: M
authors: Ghabril
authors: Julie
authors: J
authors: Otte
authors: Naga
authors: N
authors: Chalasani
authors: Raj
authors: R
authors: Vuppalanchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016014:Linear Models; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009120:Muscle Cramp / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014808:Vitamin D Deficiency / Q000150:complications* / Q000453:epidemiology