Relative Adrenal Insufficiency among Egyptian patients with liver Cirrhosis

Al-Alfy, Mohammed Noshy; Salem, Ayman Mohamed; Shaheen, Mohamed Ahmed Anwar; Hassona, Mohamed Elsayed Ebrahim Elsayed Abdullah

doi:10.21608/aimj.2025.446547

Relative Adrenal Insufficiency among Egyptian patients with liver Cirrhosis

Document Type : Original Article

Authors

¹ Internal Medicine, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Clinical Pathology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446547

Abstract

Background: Cirrhotic patients are at increased risk for refractory shock and mortality due to relative adrenal insufficiency (RAI), which occurs when the adrenal cortex does not secrete enough cortisol in response to peripheral demand. This is particularly true in severely sick patients.
Aim and objectives: To evaluate and measure RAI in Egyptian cirrhotic patients.
Patients and methods: This study was carried out from November 2023 to November 2024 at the Internal Medicine Department of Sayed Galal University Hospital on 90 patients with liver cirrhosis from Egypt.
Results: Hepatitis C affects 78 people (86.67%), non-alcoholic fatty liver disease (5.56%), hepatitis B (4.44%), autoimmune illness (2.22%), and alcohol (1.11%) are the causes of liver cirrhosis. The Child-Pugh score was significantly higher in the RAI group than in the normal adrenal function group. The child Pugh score class A was significantly lower in the relative adrenal insufficiency group than in the normal adrenal function group.
Conclusion: RAI showed a high prevalence among Egyptian patients with liver cirrhosis (43.33%). Also, RAI was associated with liver disease severity, lower Hb, WBCs, platelets, albumin, Na level, and cortisol level, and higher serum creatinine, BUN, AST, ALT, and total bilirubin.

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