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. 2022 Dec 1;117(12):1889-1893.
doi: 10.14309/ajg.0000000000001939. Epub 2022 Aug 12.

How I Approach It: Adrenal Insufficiency in Cirrhosis

Brian J Wentworth  1 , Zachary H Henry  1 , Helmy M Siragy  2
Affiliations

How I Approach It: Adrenal Insufficiency in Cirrhosis

Brian J Wentworth et al. Am J Gastroenterol. .

Abstract

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Conflict of interest statement

Conflicts of interest: none

Figures

Figure 1.
Figure 1.. Normal Adrenal Steroidogenesis.
Abbreviations: StAR, steroidogenic acute regulatory protein; 3β-HSD, 3-beta hydroxysteroid dehydrogenase; 21-OH, 21-hydroxylase; 11β-OH, 11-beta hydroxylase; 18-OH, 18-hydroxylase; 17α-OH, 17-alpha hydroxylase; 17,20, 17,20-lyase; ACTH, adrenocorticotropic hormone; AT-II, angiotensin II.
Figure 2.
Figure 2.. Potential pathophysiologic diagram of RAI.
Cytokines shown in figure are not exhaustive but representative of known pro-inflammatory cytokines upregulated in cirrhosis. Impaired adrenal enzyme activity or steroidogenesis pathway shunting (not shown here, see Figure 1) represents another potential underlying causal mechanism of RAI.
See this image and copyright information in PMC

References

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