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- W2734480591 abstract "Background and Aim: Alcoholic hepatitis (AH) is an acute hepatic inflammation associated with high morbidity and mortality. The pathogenesis of alcoholic hepatitis is complex and involve oxidative stress, gut dysbiosis, and dysregulation of the innate and adaptive immune system similar to sepsis. It has been reported that adrenal insufficiency is common in sepsis. Further treatment with steroids decreases mortality in such patients. We hypothesize that adrenal insufficiency is associated with severe alcoholic hepatitis and affects prognosis. Methods: 50 patients of alcoholic hepatitis were included in study. As per ACTH stimulation protocol the criteria to diagnose relative adrenal insufficiency rise of serum cortisol less than 7 after 1 h of inj ACTH. After a baseline 8 AM cortisol sample, inj ACTH 25 IU was injected intramuscularly and blood sample was collected after 1 h for estimation of serum cortisol. Results: In our study it was observed that out of 50 patients of alcoholic hepatitis; 7 patients (14%) had DF < 32 and 43 patients (86%) had DF > 32. Patients with DF < 32 had baseline mean serum cortisol level 9.02 μm/dl and post ACTH mean serum cortisol level was 24.12 μm/dl. Patients with DF > 32 had baseline mean serum cortisol level of 18.9 μm/dl and post-ACTH mean serum cortisol levels was 22.6 μm/dl. None of the patients with DF < 32 had evidence of relative adrenal insufficiency while 24 patients (55.8%) out of 43 patients with DF > 32; had <7 rise in serum cortisol level suggestive of relative adrenal insufficiency. Conclusion: Relative adrenal insufficiency was observed in patients with alcoholic hepatitis and it correlated with severity of AH. The cause of relative adrenal insufficiency is still not known and it may be multifactorial in etiology and may have therapeutic and prognostic implications. The authors have none to declare." @default.
- W2734480591 created "2017-07-21" @default.
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- W2734480591 date "2017-07-01" @default.
- W2734480591 modified "2023-09-30" @default.
- W2734480591 title "Relative Adrenal Insufficiency in Alcoholic Hepatitis" @default.
- W2734480591 doi "https://doi.org/10.1016/j.jceh.2017.05.086" @default.
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