Francia C Díaz1, Esteban Sáez-González1, Salvador Benlloch1, Diego Álvarez-Sotomayor2, Isabel Conde1, Begoña Polo3, María García1, María Rodríguez4, Martín Prieto1. 1. Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain. 2. * Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain. 3. Department of Paediatric Gastroenterology. La Fe University Hospital, Valencia. Spain. 4. Department of Digestive Diseases. Liver Unit. Hospital General Universitario Alicante. Spain.
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.
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.
Authors: Robin Daniel Abeles; Matthew Foxton; Shahid Khan; Robert Goldin; Belinda Smith; Mark R Thursz; Suman Verma Journal: BMJ Open Gastroenterol Date: 2020-11