Imperial College London
Alternate

ProfessorMarkThursz

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Hepatology. Head of Department
 
 
 
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Contact

 

+44 (0)20 3312 1903m.thursz

 
 
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Assistant

 

Ms Dawn Campbell +44 (0)20 3312 6454

 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Abeles:2020:10.1136/bmjgast-2020-000549,
author = {Abeles, R and Foxton, M and Khan, S and Goldin, R and Smith, B and Thursz, M and Verma, S},
doi = {10.1136/bmjgast-2020-000549},
journal = {BMJ Open Gastroenterology},
title = {Androgenic Anabolic Steroid induced liver injury: 2 cases reports assessed for causality by the updated Roussel Uclaf Causality Assessment Method (RUCAM) score and a comprehensive review of the literature},
url = {http://dx.doi.org/10.1136/bmjgast-2020-000549},
volume = {7},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background Anabolic androgenic steroids (AAS) usage is widespread and increasing. AAS drug-induced liver injury (DILI) is recognised but its clinical course and management is poorly described. We report 2 cases of AAS DILI with associated renal dysfunction, managed successfully with oral corticosteroids.Methods A comprehensive review identified 50 further cases to characterise the clinical and biochemical course. Causality grading was calculated using the updated Roussel Uclaf Causality Assessment Method (RUCAM) score. Data are presented as median values.Results The most common AAS taken was methyldrostanolone. Patients commonly present with jaundice and pruritus but may exhibit other constitutional symptoms. Patients presented 56 days after starting, and bilirubin peaked 28 days after stopping, AAS. Causality assessment was ‘unlikely’ in 1 (2%), ‘possible’ in 31 (60%) and ‘probable’ in 20 (38%). Peak values were: bilirubin 705 μmol/L, alanine transaminase 125 U/L, aspartate transaminase 71 U/L, alkaline phosphatase 262 U/L, gamma-glutamyl transferase 52 U/L, international normalised ratio 1.1. Liver biopsies showed ‘bland’ canalicular cholestasis. 43% of patients developed kidney injury (peak creatinine 225 μmol/L). Therapies included antipruritics, ursodeoxycholic acid and corticosteroids. No patients died or required liver transplantation.Conclusions Physicians are likely to encounter AAS DILI. Causality assessment using the updated RUCAM should be performed but defining indications and proving efficacy for therapies remains challenging.
AU  - Abeles,R
AU  - Foxton,M
AU  - Khan,S
AU  - Goldin,R
AU  - Smith,B
AU  - Thursz,M
AU  - Verma,S
DO  - 10.1136/bmjgast-2020-000549
PY  - 2020///
SN  - 2054-4774
TI  - Androgenic Anabolic Steroid induced liver injury: 2 cases reports assessed for causality by the updated Roussel Uclaf Causality Assessment Method (RUCAM) score and a comprehensive review of the literature
T2  - BMJ Open Gastroenterology
UR  - http://dx.doi.org/10.1136/bmjgast-2020-000549
UR  - http://hdl.handle.net/10044/1/84573
VL  - 7
ER  -
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