Vitamin B 12 Associated Peripheral Neuropathy in Cirrhosis of Liver – A Cross Sectional Study

Introduction-Peripheral neuropathy (PN) is commonly associated with cirrhosis of liver. Vitamin B12 is stored in liver and its storage is hampered in liver cirrhosis. Vitamin B12 deficiency appears to be the most common reversible cause for PN. Aims&ObjectivesWe evaluated correlation between serum vitamin B12 levels and PN in patients of cirrhosis of liver. 2. To study prevalence and pattern of PN and its association with different etiology and severity in patients of cirrhosis of liver. Methodology-Cross sectional study was conducted in which total 100 patients with liver cirrhosis were assessed clinically for PN and confirmed by nerve conduction studies. Results-Out of 100 patients, only 5 patients showed clinical signs of PN. 75 patients were clinically asymptomatic with abnormal nerve conduction studies showing polyneuropathy(52%) and mononeuropathy(48%).Majority of patients(89.2%)of PN was present in Child Pugh C class. Serum vitamin B12 and homocysteine levels were elevated in 75% of patients. A significant & positive correlation was observed between vitamin B12 and homocysteine level. Raised serum vitamin B12 level due to hepatocellular damage and leakage of vitamin B12 into the circulation & raised serum homocysteine levels indirectly reflects hepatocellular vitamin B12 deficiency. Conclusion: Vitamin B12 may be a causative or precipitating factor for PN in cirrhosis of liver.