Assessment of Adrenal Function in Chronic Hepatitis C Patients

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.