Abstract
Assessment of Adrenal Function in Chronic Hepatitis C Patients
Highlights
Hepatitis C viral infection is endemic in Egypt with the highest prevalence rate in the world
Liver failure shares many clinical similarities to septic shock. Both conditions are characterized by the presence of hyperdynamic circulatory failure, with a low mean arterial pressure, decreased systemic vascular resistance, and increased cardiac output (Grune & Berger, 2007). Elevated cytokine levels, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α, can be observed in both conditions, and liver failure leads to decreased monocyte function and immunoparalysis, a finding first noted in patients with septic shock (Wasmuth et al, 2005) many studies of Adrenal insufficiency (AI) in liver failure have been reported based on the similarity between liver failure and sepsis
We found a statistical significant difference between different liver function as regard serum albumin, INR, Total and direct bilirubin which were more affected in decompensated patients than other groups, this goes with de Mattos et al, (2016) who declared that Patients with cirrhosis have impaired hepatocellular function and reduced albumin synthesis, which can reach a 60-80% reduction in advanced cirrhosis
Summary
Hepatitis C viral infection is endemic in Egypt with the highest prevalence rate in the world. Around 30% of patients may clear the virus spontaneously, the main health burden occurs from the majority of patients who develop chronic HCV In this patient population, cirrhosis may develop within 20 years of infection, with hepatic decompensation and hepatocellular carcinoma (Vos et al, 2015). AI in cirrhosis is an issue that has recently gained momentum It can be seen in both stable and critically ill (sepsis, septic shock, and gastrointestinal system bleeding) cirrhotic patients. AI has been shown to correlate with progression of liver disease 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.
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