HAND SKIN TEMPERATURE-CHANGES IN PATIENTS WITH CHRONIC LIVER-DISEASE

Previous studies have shown that changes in the peripheral circulation occur in patients with liver disease. We have investigated the temper ature of the hands of 26 patients and 13 controls using a liquid cryst al contact thermography system. Significant differences in resting han d temperature and appearance were observed when the patients were cate gorised according to Child's score. The appearance depended upon the s everity of liver disease; Child's A patients have warm hands of normal thermographic appearance; Child's B patients have cold hands with an abnormal thermographic appearance; whilst Child's C patients have warm hands with an abnormal thermographic appearance. After right-hand ice -cold water immersion, right-hand recovery was abnormally slow in Chil d's B and C groups compared with Child's A patients and controls. In a ddition, there was left-hand reflex vasoconstriction during the right- hand warm-up period in those with severe liver disease. With regard to autonomic function, no significant difference in right-hand temperatu re, thermographic appearance or warm-up rate was detected between thos e with and those without autonomic neuropathy. These results indicate that autonomic nervous system dysfunction is not the predominant cause of these changes. (C) Journal of Hepatology.