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Sepsis as a Pan-Endocrine Illness-Endocrine Disorders in Septic Patients

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 10, Pages -

Publisher

MDPI
DOI: 10.3390/jcm10102075

Keywords

sepsis; septic shock; inflammation; critical illness; intensive care; metabolism; hormones; endocrinology

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Sepsis causes dysregulation of the endocrine system, affecting multiple hormonal axes such as the hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-thyroid axis, and somatotropic axis. This can lead to issues such as decreased sex hormone levels, amenorrhea, and altered hormone secretion patterns.
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. One of the elements of dysregulated host response is an endocrine system disorder. Changes in its functioning in the course of sepsis affect almost all hormonal axes. In sepsis, a function disturbance of the hypothalamic-pituitary-adrenal axis has been described, in the range of which the most important seems to be hypercortisolemia in the acute phase. Imbalance in the hypothalamic-pituitary-thyroid axis is also described. The most typical manifestation is a triiodothyronine concentration decrease and reverse triiodothyronine concentration increase. In the somatotropic axis, a change in the secretion pattern of growth hormone and peripheral resistance to this hormone has been described. In the hypothalamic-pituitary-gonadal axis, the reduction in testosterone concentration in men and the stress-induced hypothalamic amenorrhea in women have been described. Catecholamine and beta-adrenergic stimulation disorders have also been reported. Disorders in the endocrine system are part of the dysregulated host response to infection. They may also affect other components of this dysregulated response, such as metabolism. Hormonal changes occurring in the course of sepsis require further research, not only in order to explore their potential significance in therapy, but also due to their promising prognostic value.

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