Acrocyanosis A Manifestation of Autonomic Dysfunction in Chronic Liver Disease-Case Report

Authors

  • Inês Ângelo Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal Author
  • Joana Lopes Ferreira Resident Physician MD, Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal Author
  • Joaquim Peixoto Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal Author
  • Martinho Fernandes Chief of the Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal Author

DOI:

https://doi.org/10.47363/JGHR/2022(3)136

Keywords:

Autonomic Dysfunction, Ethanolism, Acrocyanosis, Orthostatism

Abstract

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.

Author Biographies

  • Inês Ângelo, Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal


    Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

  • Joana Lopes Ferreira, Resident Physician MD, Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal


    Resident Physician MD, Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

  • Joaquim Peixoto, Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

    Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

  • Martinho Fernandes, Chief of the Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

    Chief of the Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, Portugal

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Published

2022-05-18