Effect of hepatosplenic schistosomiasis on the hypothalamic-Pituitary-adrenal axis

ABSTRACT

To test the hypothalamic pituitary adrenal axis in hepatosplenic schistosomiasis [HSS], 40 adult Egyptian males were selected. They were composed of 4 groups Compensated HSS [G1], decompensated HSS [G2], HSS with bilateral gynecomastia [G3] and healthy controls [G4]. They were subjected to full clinical examination and routine laboratory tests in addition to the ACTH and cortisol levels in plasma before [basal level] and after insulin-induced hypoglycemia as a dynamic test. The basal level of plasma ACTH in patients with compensated HSS was found to be significantly lower than that of the control [P <0.05]. It was even lower in the controls and in HSS associated with gynecomastis [P <0.001]. After insulin induced hypoglycemia, the level of ACTH was found to be significantly low in G2 and G3 compared with the controls. The level after stimulation was higher than the basal level in all groups including the controls. On the other hand, the basal level of serum cortisol was significantly low in patients with gynecomastia only compared with the controls. While, after insulin induced hypoglycemia the levels were found to be significantly low in G1 and G3 [P <0.001]. No correlations were found between serum albumin, SGPT or alkaline phosphatase and ACTH or cortisol levels. These findings could have its own application when a patient with HSS should undergo a major surgery