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[Adrenal insufficiency in cirrhosis].
- Source :
-
Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2008 Nov; Vol. 31 (9), pp. 606-11. - Publication Year :
- 2008
-
Abstract
- Cortisol is a pluripotent hormone that is vital in the host adaptation to stress. It is essential to maintain the normal vascular tone, endothelial integrity and vascular permeability. Consequently, the failure of an appropriate adrenal response in the setting of critical illness, alteration known as relative adrenal insufficiency, may have important clinical consequences. The diagnosis of this entity is not possible on clinical grounds and relies on the measurement of plasma cortisol levels prior and after adrenal stimulation with synthetic corticotrophin. Several studies performed in the general population have shown that relative adrenal insufficiency contributes to vascular hyporesponsiveness in septic shock and increases mortality. However, contradictory data exist regarding the effects of hydrocortisone administration in these patients. Moreover, recent studies indicate that relative adrenal insufficiency is very frequent in patients with advanced cirrhosis and septic shock and in fulminant hepatic failure. This chapter summarizes the main aspects of the physiopathology, diagnosis and treatment of this entity in patients with acute or chronic liver disease.
- Subjects :
- Adrenal Insufficiency diagnosis
Adrenal Insufficiency drug therapy
Adrenal Insufficiency physiopathology
Adrenocorticotropic Hormone
Critical Illness
Disease Susceptibility
Humans
Hydrocortisone physiology
Hydrocortisone therapeutic use
Hypothalamo-Hypophyseal System physiopathology
Liver Failure, Acute complications
Liver Failure, Acute physiopathology
Pituitary-Adrenal System physiopathology
Prospective Studies
Retrospective Studies
Shock, Septic etiology
Stress, Physiological
Survival Analysis
Adrenal Insufficiency etiology
Liver Cirrhosis complications
Subjects
Details
- Language :
- Spanish; Castilian
- ISSN :
- 0210-5705
- Volume :
- 31
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Gastroenterologia y hepatologia
- Publication Type :
- Academic Journal
- Accession number :
- 19091250
- Full Text :
- https://doi.org/10.1157/13128301