Abstract
Background and aims. Steroid-related hepatotoxicity has become one of the most relevant causes of drug induced liver cholestasis. Some patients do not improve after standard medical treatment (SMT) and may therefore require other approaches, like extracorporeal liver support.
Material and methods:
We report four cases of patients with pruritus, abnormal liver function tests and biopsy-proven anabolic steroid-induced cholestasis who were unresponsive to SMT. They underwent treatment with albumin dialysis (Molecular Adsorbent Recirculating System -MARS®-). A minimum of two MARS sessions were performed.
Results:
After MARS® procedure, patients' symptoms improved, as well as liver function tests, thus avoiding liver transplantation.
Conclusion:
Albumin dialysis appears as a valuable therapeutic option for the management of anabolic steroid-induced cholestasis in patients that are unresponsive to SMT.
MeSH terms
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Adult
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Anabolic Agents / adverse effects*
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Androstanols / adverse effects*
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Chemical and Drug Induced Liver Injury / blood
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Chemical and Drug Induced Liver Injury / diagnosis
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Chemical and Drug Induced Liver Injury / etiology
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Chemical and Drug Induced Liver Injury / therapy*
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Cholestasis, Intrahepatic / blood
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Cholestasis, Intrahepatic / chemically induced
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Cholestasis, Intrahepatic / diagnosis
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Cholestasis, Intrahepatic / therapy*
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Humans
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Liver Function Tests
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Male
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Membranes, Artificial
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Protein Binding
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Pruritus / chemically induced
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Recovery of Function
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Serum Albumin / administration & dosage*
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Serum Albumin, Human
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Sorption Detoxification / instrumentation
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Sorption Detoxification / methods*
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Testosterone Congeners / adverse effects*
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Time Factors
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Treatment Outcome
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Young Adult
Substances
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ALB protein, human
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Anabolic Agents
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Androstanols
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Membranes, Artificial
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Serum Albumin
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Testosterone Congeners
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epitiostanol
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Serum Albumin, Human