Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Introduction: Liver cirrhosis is a major cause of mortality worldwide (Méndez et al., 2007) often with severe sepsis as the terminal event (Tsai, et al, 2006). Over the last two decades, several studies have reported that in septic patients the adrenal glands respond inappropriately to stimulation, and that the treatment with corticosteroids decreases mortality in such patients (Annane et al 2004). Conclusion: In conclusion, AI forms important part of spectrum of chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically. Adrenal function worsens with progression of liver disease. Steroid replacement in CLD patients at time of stress and critical illness may be beneficial

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