title: [Recurrent acute liver toxicity from intravenous methylprednisolone].
abstract: Adverse drug reactions (hepatotoxicity) are a frequent cause of acute liver injury with a wide clinical and histological spectrum. An early recognition of drug-related liver disease has been considered essential in clinical practice due to potential risks. In most cases exposure discontinuation improves the clinical picture.Steroids are used in a variety of clinical settings. However, intravenous steroids have rarely been associated with hepatotoxicity. We report the case of a middle-aged woman with multiple sclerosis who received a bolus of methylprednisolone on three occasions for the management of relapsing disease, with the development of repeated episodes of elevated liver enzymes after corticoid administration. In the third episode a liver biopsy was performed, which showed acute hepatitis with bridging necrosis; such histological picture has not been described before in patients treated with intravenous steroids.
authors.affiliation: Servicios de Gastroenterología, Hospital Ramón y Cajal. Madrid. Spain. rivernautaes@yahoo.es
authors.forename: M
authors.initials: M
authors.lastname: Rivero Fernández
authors.forename: J M
authors.initials: JM
authors.lastname: Riesco
authors.forename: V F
authors.initials: VF
authors.lastname: Moreira
authors.forename: A
authors.initials: A
authors.lastname: Moreno
authors.forename: A
authors.initials: A
authors.lastname: López San Román
authors.forename: G
authors.initials: G
authors.lastname: Arranz
authors.forename: L
authors.initials: L
authors.lastname: Ruiz Del Arbol
mesh_terms: D000208:Acute Disease; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008099:Liver / Q000473:pathology; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy; D009336:Necrosis; D012008:Recurrence
chemical_list: D008775:Methylprednisolone