CLINICAL SPECTRUM OF NON ALCOHOLIC CIRRHOSIS

Cirrhosis liver is a major health problem world wide and specially in developing countries like Pakistan. It is defined as necrosis of liver followed by fibrosis and regeneration. Alcohol and viral hepatitis are the two important causes of cirrhosis. Clinical presentation of cirrhosis depends on stage of cirrhosis whether compensated or de-compensated. Most of the clinical features are common to all types but there are certain features, which are more common in one type than the other. This prospective study was conducted to find the frequency of various clinical features of non-alcoholic cirrhosis and to compare it with those reported in literature. Hundred patients of cirrhosis admitted to Medical Unit of Khyber Teaching Hospital Peshawar between March 1997 to Dec 1997 were included in the study. All the relevant details regarding history, clinical examination and investigations were recorded in specially designed proforma. The commonest presenting features were abdominal distension (61%), generalised weakness (55%), pain abdomen (52%), anorexia (45%), fatigue (38%), low grade fever (38%), nausea and vomiting (36%), swelling of feet (35%), haematemesis (33%), loss of libido (33%) and weight loss (25%). The commonest signs observed were splenomegaly (75%), anaemia (72%), ascites (65%), oedema feet (43%), jaundice (40%), leukonychia (40%), palmer erythema (35%), hepatomegaly (30%), muscle wasting (30%), bruises (27%), clubbing (24%),loss of body hair (18%), spider naevi (18%),testicular atrophy (15%) and gynaecomastia (12%). Viruses specially HBV and HCV were the main aetiological factors (76%). The data indicates that clinical features found in this study are not very different from other parts of Pakistan. Dupuytren s contractures, parotid gland enlargement and gynaecomastia are rare in our population as compared to that in western literature (alcohol in the west and viral hepatitis in our population)