Endocrine disorders in burn disease. Literature review

Abstract

The purpose of the review is to highlight clinically hidden variants of hormonal dysfunctions in burn disease, which strongly determine the peculiarities of the course of the pathological condition but are often overlooked by clinicians. Based on available literary sources, this study provides a comprehensive analysis of specialised medical reports from both domestic and foreign researchers. The focus of this analysis was on compensatory and pathological shifts in hormonal regulation of the body in individuals suffering from local heat injury. The collected scientific data is expected to be useful to practitioners in the field of combustiology in their practical activities. Damage to the endocrine glands is one of the key pathogenetic factors of local thermal injury, but the intracellular mechanisms of the influence of burn disease on these processes remain poorly understood. The criticality of burn injuries often leads to hypodiagnosis of endocrine disorders, which are indeed typical and rapidly developing. The neuroendocrine response to severe burns is a multisystem coordinated response of the body, which can not only maintain homeostasis and play a protective role in critical conditions but also cause tissue damage, realising the properties of a «double‑edged sword». Burns covering more than 40% of the total surface area of the body are accompanied by a stress reaction and hyperinflammation with a steady increase in the secretion of catecholamines, glucocorticoids, and cytokines. Classic studies confirm that a sharp post‑burn increase in stress hormones (adrenaline, norepinephrine, glucagon, and cortisol) contributes to the development of hyperglycemia, a systemic catabolic state, and multiple organ dysfunction. It has been established that the hypothalamic‑pituitary axis is responsible for fluctuations in the content of pituitary hormones in the blood serum of patients with local thermal lesions. After severe burns, the plasma renin‑angiotensin‑aldosterone system is activated, and the level of some hormones increases for more than 2 months after the injury.