Adrenal insufficiency (AI) has been recorded in 9%-83% of stable cirrhotic patients. AI has been described in all stages of cirrhosis, including critically ill or stable patients. Some studies even argue that adrenal failure is a feature of liver dysfunction. However, making a diagnosis is challenging as the conventional diagnostic methods - serum total cortisol levels may be inaccurate due to changes in serum concentrations of cortisol-binding globulin (CBG) and albumin. We present a patient with a MELD score of 30 and Maddrey's score of 129, with recurrent electrolyte abnormalities, who was presumed to have AI and responded to steroids.
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Kiratt et al. (2024) studied this question.
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