Why the study?
Autonomic dysfunction can manifest in chronic liver disease, but its pathophysiological mechanism remains somewhat misunderstood.
Acrocyanosis can be an atypical presentation of autonomic dysfunction, specifically orthostatic hypotension and POTS, in patients with chronic liver disease.
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May prompt autonomic testing in CLD with orthostatic symptoms; leaves open prevalence and management implications.
Autonomic dysfunction (AD) can manifest in Chronic liver disease (CLD), whose pathophysiological mechanism remains somewhat misunderstood. The following case reports a 57-year-old patient, hospitalized because of his decompensated CLD-ethanolic etiology-who started with an acrocyanosis condition in the lower limbs, after positional change to orthostatism. With other causes excluded, his blood pressure (BP) variation and his heart rate (HR) were analyzed. The latter allowed a diagnosis of Orthostatic Hypotension (OH) and Postural Orthostatic Tachycardia Syndrome (POTS), which can be frequently considered as manifestations of AD. There is a high percentage of CLD of ethanolic etiology patients that suffer from alterations in the autonomous nervous system caused by decreased function of baroreceptors to positional variations. This clinical case aims to exhibit an atypical presentation of two entities that characterize AD and may be present in these patients.
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Inês Ângelo (2022) studied this question.
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