Assessment of Adrenal Function in Chronic Hepatitis C Patients

Document Type : Original Article

Authors

Department of Internal Medicine, Faculty of Medicine, Minia University, Egypt.

Abstract

Background: Adrenal insufficiency (AI) was demonstrated in patients with cirrhosis and liver failure. 
A relationship appears to exist between the severity of the liver disease and the presence of RAI. AI 
has been shown to correlate with progression of liver disease. It can be seen in both stable and 
critically ill (sepsis, septic shock, and gastrointestinal system bleeding) cirrhotic patients. RAI is a 
feature of liver disease per se, leading to what is termed hepatoadrenal syndrome. The aim of our 
study: was to Detection of serum cortisol level and ACTH level in patients with Chronic hepatitis C 
and liver cirrhosis and Correlation between severity of liver disease and Adrenal insufficiency.
Methods: this cross-sectional hospital-based study was conducted in Internal Medicine Department, 
Minia University Hospital from June 2018 to June 2019, and included 240 patients divided into the 
following groups: First group: It included 60 patients with chronic HCV. Second group: It included 60 
patients with HCV-related compensated cirrhosis. Third group: it includes 60 patients with HCV 
decompensated cirrhosis. fourth group: 60 people (healthy volunteers) with matched age and sex to 
patients' group. Results: increase in percentage of patients with adrenal dysfunction with progression 
of liver disease. Also, we found significantly higher level of INR, RBS, Alt and Total bilirubin in AI 
group than normal one and significantly lower Hb level, Serum albumin and Platelet count in group 
with AI Vs normal one. Conclusion: serum albumin level was lower, and INR was higher in patients 
with AI than in those without adrenal insufficiency, Adrenal function worsens with progression of 
liver disease.

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