[Severe cholestasis with kidney failure from anabolic steroids in a body builder].
METHODS
A 28-year-old body builder was admitted because of jaundice. For 80 days, until 3 weeks before hospitalization, he had been taking moderately high doses of anabolic steroids: metandienone (methandienone), 10-50 mg daily by mouth, and stanozolol, 50 mg intramuscularly every other day. Physical examination was unremarkable except for yellow discoloration of the skin and sclerae.


METHODS
Bilirubin concentration was raised to 4.5 mg/dl, cholestasis enzymes were normal, while transaminase activities were raised. Liver biopsy was compatible with cholestasis induced by anabolic steroids.


METHODS
Although the steroids had been discontinued, the patient's general condition deteriorated over 7 weeks. Serum bilirubin rose up to a maximum of 77.9 mg/dl. In addition renal failure developed with a creatinine concentration of 4.2 mg/dl. The patient's state improved simultaneously with the administration of ursodeoxycholic acid and the biochemical values gradually reached normal levels after several weeks.


CONCLUSIONS
Anabolic steroids can cause severe cholestasis and acute renal failure. In this case there was a notable temporal coincidence between the administration of ursodeoxycholic acid and the marked clinical improvement.
Habscheid
W
W
Medizinische Klinik, Paracelsus-Krankenhaus Ruit, Esslingen.
Abele
U
U
Dahm
H H
HH
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D045930:Anabolic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001707:Biopsy, Needle; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D002779:Cholestasis / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D003692:Delayed-Action Preparations; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008696:Methandrostenolone / Q000008:administration & dosage / Q000009:adverse effects*; D013197:Stanozolol / Q000008:administration & dosage / Q000009:adverse effects*
D045930:Anabolic Agents; D003692:Delayed-Action Preparations; D013197:Stanozolol; D008696:Methandrostenolone