The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use
Drug-induced liver injury (DILI) presents as a broad spectrum of adverse drug reactions which can range from a mild elevation in liver enzymes to fulminant liver failure. The primary goal is to identify DILI early when the patient’s liver enzymes are elevated and to discontinue the offending agent a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2016-09-01
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| Series: | Case Reports in Gastroenterology |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/448883 |
| _version_ | 1817998161618141184 |
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| author | Elena Cabb Shanna Baltar David Wes Powers Karthik Mohan Antonio Martinez Eric Pitts |
| author_facet | Elena Cabb Shanna Baltar David Wes Powers Karthik Mohan Antonio Martinez Eric Pitts |
| author_sort | Elena Cabb |
| collection | DOAJ |
| description | Drug-induced liver injury (DILI) presents as a broad spectrum of adverse drug reactions which can range from a mild elevation in liver enzymes to fulminant liver failure. The primary goal is to identify DILI early when the patient’s liver enzymes are elevated and to discontinue the offending agent as soon as possible to prevent further injury. Herbal, dietary supplements and anabolic steroids represent a significant component of the drugs thought to cause DILI in the United States. Unlike all other drugs known to cause DILI, these drugs fall into a category of injury that is neither intrinsic nor idiosyncratic due to overlapping characteristics between the two. Here, we present a case of the off-label use of androgenic anabolic steroids inducing liver injury. A combination of clinical, laboratory, and histologic workup eventually led to the diagnosis of DILI. This can be a diagnostic challenge for practitioners. The American College of Gastroenterology (ACG) published guidelines to aid the clinician in diagnosing DILI. Proving that an episode of liver injury is caused by a drug is difficult in many cases as it requires the exclusion of alternative etiologies. Some of the variables include temporal association, clinical-biochemical features, type of injury (hepatocellular and/or cholestatic), extrahepatic features, and the likelihood that a given agent is the culprit based on its known manifestations with prior cases. This case illustrates the utility of the diagnostic tools used for DILI as recommended by the ACG, along with a supplemental histopathologic diagnosis. |
| first_indexed | 2024-04-14T02:49:32Z |
| format | Article |
| id | doaj.art-ce26dfb50a324ea380bf9c787e28d9b1 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-04-14T02:49:32Z |
| publishDate | 2016-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-ce26dfb50a324ea380bf9c787e28d9b12022-12-22T02:16:22ZengKarger PublishersCase Reports in Gastroenterology1662-06312016-09-0110249950510.1159/000448883448883The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid UseElena CabbShanna BaltarDavid Wes PowersKarthik MohanAntonio MartinezEric PittsDrug-induced liver injury (DILI) presents as a broad spectrum of adverse drug reactions which can range from a mild elevation in liver enzymes to fulminant liver failure. The primary goal is to identify DILI early when the patient’s liver enzymes are elevated and to discontinue the offending agent as soon as possible to prevent further injury. Herbal, dietary supplements and anabolic steroids represent a significant component of the drugs thought to cause DILI in the United States. Unlike all other drugs known to cause DILI, these drugs fall into a category of injury that is neither intrinsic nor idiosyncratic due to overlapping characteristics between the two. Here, we present a case of the off-label use of androgenic anabolic steroids inducing liver injury. A combination of clinical, laboratory, and histologic workup eventually led to the diagnosis of DILI. This can be a diagnostic challenge for practitioners. The American College of Gastroenterology (ACG) published guidelines to aid the clinician in diagnosing DILI. Proving that an episode of liver injury is caused by a drug is difficult in many cases as it requires the exclusion of alternative etiologies. Some of the variables include temporal association, clinical-biochemical features, type of injury (hepatocellular and/or cholestatic), extrahepatic features, and the likelihood that a given agent is the culprit based on its known manifestations with prior cases. This case illustrates the utility of the diagnostic tools used for DILI as recommended by the ACG, along with a supplemental histopathologic diagnosis.http://www.karger.com/Article/FullText/448883Liver injuryAndrogenic anabolic steroidsHistopathology |
| spellingShingle | Elena Cabb Shanna Baltar David Wes Powers Karthik Mohan Antonio Martinez Eric Pitts The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use Case Reports in Gastroenterology Liver injury Androgenic anabolic steroids Histopathology |
| title | The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use |
| title_full | The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use |
| title_fullStr | The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use |
| title_full_unstemmed | The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use |
| title_short | The Diagnosis and Manifestations of Liver Injury Secondary to Off-Label Androgenic Anabolic Steroid Use |
| title_sort | diagnosis and manifestations of liver injury secondary to off label androgenic anabolic steroid use |
| topic | Liver injury Androgenic anabolic steroids Histopathology |
| url | http://www.karger.com/Article/FullText/448883 |
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