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hepatoadrenal syndrome

Ming-Hung Tsai, Hui-Chun Huang, Yun-Shing Peng, Yung-Chang Chen, Ya-Chung Tian, Chih-Wei Yang, Jau-Min Lien, Ji-Tseng Fang, Cheng-Shyong Wu, Sen-Yung Hsieh, Fa-Yauh Lee
BACKGROUND: Cirrhotic patients are susceptible to sepsis and critical illness-related corticosteroid insufficiency (CIRCI). Dehydroepiandrosterone sulfate (DHEAS) is a corticotropin-dependent adrenal androgen, which has immunostimulating and antiglucocorticoid effects. Considering the synchronized synthesis of cortisol and DHEAS and their opposing effects to each other, investigators have proposed measuring these two hormones as a ratio. Severe sepsis has been associated with low DHEAS, especially relative to high cortisol...
August 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
J Zhang, H-W Yu, J Li, Y-K Zhu, K-F Wang, L Jia, Q-H Meng
In liver cirrhosis with bacterial infection, hepatoadrenal syndrome has been described recently as a progressive impairment in the adrenocortical reserve, with deficient production or action of glucocorticoids resulting in adrenal insufficiency. The aim of this study was to explore the characteristics of cortisol in hepatitis B virus (HBV) cirrhosis patients in the absence of bacterial infection. Fasting peripheral venous blood samples were collected from 107 patients with HBV cirrhosis in the absence of bacterial infection and 18 patients with chronic hepatitis B (CHB) infection at 7 a...
2015: Genetics and Molecular Research: GMR
Fa-Yauh Lee, Sun-Sang Wang, Ming-Hung Tsai, Hui-Chun Huang, Han-Chieh Lin, Shou-Dong Lee
Nitric oxide (NO) participates in shock and poorer portal hypotensive effect to vasoconstrictors in portal hypertension with hemorrhage, the so-called splanchnic hyposensitivity. Relative adrenal insufficiency accompanies hemorrhagic shock and is found in liver disease, the 'hepatoadrenal syndrome', but the relevant interactions remain unsettled. Portal hypertensive rats were induced by partial portal vein ligation (PVL). Experiments were performed on the 14th day post PVL: (I) ACTH stimulation test for rats without or with hemorrhage; (II) Glypressin response (mean arterial pressure, MAP; portal pressure, PP) in rats (a) without hemorrhage or with hemorrhage, injected with (b) distilled water (DW), (c) dexamethasone 3 mg/kg; (III) To survey the dose-dependent effects of glucocorticoid without being confounded by endogenous adrenal hormone, glypressin response was surveyed in PVL rats with adrenalectomy: (a) without hemorrhage or with hemorrhage, injected with (b) DW; (c) dexamethasone 3 mg/kg; (d) dexamethasone 5 mg/kg...
2014: PloS One
Seong-Soo Choi, Jihion Yu, Young-Kug Kim, Gyu-Sam Hwang
Adrenal insufficiency, which is related to hemodynamic instability and increased mortality, has been reported in patients with advanced liver disease regardless of the presence of septic conditions. In this regard, the hepatoadrenal syndrome has been recently proposed as adrenal insufficiency in critically ill patients with liver disease. We describe here a 67-year-old female patient with hepatic failure and adrenal insufficiency. The patient showed stable vital signs and no evidence of sepsis preoperatively...
June 2013: Korean Journal of Anesthesiology
Tania Tomaselli, Graziella Privitera, Giuseppe Fede, Luisa Spadaro, Roberto Scicali, Rossella Di Vita, Domenico Compagnone, Francesco Purrello
In liver cirrhosis, hepatoadrenal syndrome has been described recently as a progressive impairment in the adrenocortical reserve, with deficient production or action of glucocorticoids resulting in adrenal insufficiency. Data on the treatment of this syndrome are scarce. We report a case of a 60-year-old male patient referred to our hospital because of rectal bleeding and bilateral leg swelling. He complained of marked weakness, bilateral leg swelling, and shortness of breath with exertion for the last 2 months...
November 2012: European Journal of Gastroenterology & Hepatology
Kyle A Soltys, George V Mazariegos
No abstract text is available yet for this article.
May 2012: Pediatric Critical Care Medicine
Gabriel J Hauser, Hannah M Brotzman, Stuart S Kaufman
OBJECTIVE: Adrenal insufficiency in patients with liver failure, referred to as hepatoadrenal syndrome, is well characterized in adult patients but has not yet been described in children. We present 22 pediatric subjects with end-stage liver disease and adrenal insufficiency, diagnosed using the cosyntropin stimulation test. DESIGN AND SETTING: A retrospective chart review using inpatient records from a pediatric intensive care unit in an academic medical center with a busy pediatric transplant program...
May 2012: Pediatric Critical Care Medicine
James O'Beirne, Michael Holmes, Banwari Agarwal, Pierre Bouloux, Steve Shaw, David Patch, Andrew Burroughs
Recently, treatment with corticosteroids in the setting of septic shock and adrenal insufficiency has been shown to decrease mortality. In septic patients, a blunted response to adrenal stimulation identifies patients with a poorer prognosis who may benefit from corticosteroid supplementation. This condition has been termed relative adrenal insufficiency (RAI). Given the similarities between septic shock and liver failure, a number of groups have now studied the incidence of RAI in various forms of liver disease...
September 2007: Journal of Hepatology
Paul E Marik, Timothy Gayowski, Thomas E Starzl
OBJECTIVE: Adrenal failure is common in critically ill patients, particularly those with sepsis. As liver failure and sepsis are both associated with increased circulating levels of endotoxin and proinflammatory mediators and reduced levels of apoprotein-1/high-density lipoprotein, we postulated that adrenal failure may be common in patients with liver disease. DESIGN: Clinical study. SETTING: Liver transplant intensive care unit. PATIENTS: The study cohort included 340 patients with liver disease...
June 2005: Critical Care Medicine
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