Assessment of Adrenal Function in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Abstract

Background: One of the subjects that has become a big issue in recent years is adrenal Insuffi-ciency in cirrhotic patients, it is evidenced that there is an argument association between cir-rhotic patients with spontaneous bacterial peritonitis and adrenocortical dysfunction. Aim: to assess adrenal function in chronic liver disease patients with spontaneous bacterial peritonitis to measure hepato-adrenal syndrome problem in our patients. Subjects and Methods: cross sectional analytic study was carried out including 160 persons divided into 4 groups, 40 pa-tients for each. Group1(healthy or control group), Group2 (Patients with compensated liver disease), Group 3 (patients with cirrhotic liver disease and sterile ascites and Group 4( patients with cirrhotic liver disease and spontaneous bacterial peritonitis), Then serum cortisol level was assessed for each group at 8a.m , 8p.m and post synacthen test then the comparison was held to assess adrenal function among them. Results: Our study revealed statistically signifi-cant differences between the comparative groups with pre and post synacthen test where adrenal insufficiency was clear. P-value was (0.001), mean value of total neutrophilic count (p=<0.001), relation between adrenal insufficiency and Child-Pugh score (p= <0.001). Conclu-sion: Spontaneous bacterial peritonitis plays a very major role in adrenal insufficiency.