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ALS - Motor Neuron Disease: Mechanism and Development of New Therapies
Published on: July 29, 2007
Historia natural de la neuropatía autónoma en la enfermedad hepática crónica
M T Hendrickse1, P J Thuluvath, D R Triger
1Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK.
Lancet (London, England)
|June 13, 1992
Resumen
La neuropatía autónoma, específicamente la neuropatía vagal, es común en la enfermedad hepática crónica. Los pacientes con esta condición se enfrentan a un riesgo de mortalidad significativamente mayor, destacando su importancia en el pronóstico.
Área de la Ciencia:
- Cardiología Cardiología.
- Hepatología Hepatología.
- Neurología Neurología.
Sus antecedentes:
- La enfermedad hepática crónica (ECC) afecta a múltiples sistemas de órganos.
- La disfunción autónoma es una complicación conocida de la DLC.
- La historia natural y el significado pronóstico de la neuropatía autónoma en CLD requieren una mayor aclaración.
Objetivo del estudio:
- Evaluar prospectivamente la prevalencia y la historia natural de la neuropatía autónoma en pacientes con DLC.
- Evaluar la asociación entre la neuropatía autónoma y la mortalidad en pacientes con ECL.
- Para identificar los predictores de la mortalidad en esta cohorte.
Principales métodos:
- Evaluación prospectiva de 60 pacientes con DLC con función hepática preservada.
- Se emplearon pruebas estándar de función autónoma cardiovascular.
- Se realizaron pruebas en serie para monitorear la progresión y la reversibilidad de la enfermedad.
Principales resultados:
- La neuropatía vagal estaba presente en el 45% de los pacientes en las pruebas iniciales.
- La disfunción autónoma fue igualmente prevalente en las enfermedades hepáticas relacionadas con el alcohol y no relacionadas con el alcohol.
- La mortalidad a cuatro años fue del 30% en pacientes con neuropatía vagal frente al 6% en aquellos sin ella.
- La neuropatía vagal y la gravedad del daño hepático predijeron de forma independiente la mortalidad.
Conclusiones:
- La disfunción vagal es un hallazgo común en la enfermedad hepática crónica bien compensada.
- La presencia de neuropatía vagal identifica un subgrupo de alto riesgo con un peor pronóstico.
- Las anomalías de la función autónoma pueden ser progresivas o reversibles en la CLD.
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