title: Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder.
abstract: Heart failure may lead to subclinical circulatory disturbances and remain an unrecognized cause of ischemic liver injury. We present the case of a previously healthy 40-year-old bodybuilder, referred to our Intensive-Care Unit of Hepatology for treatment of severe acute liver failure, with the suspicion of toxic hepatitis associated with anabolic steroid abuse. Despite the absence of symptoms and signs of congestive heart failure at admission, an anabolic steroid-induced dilated cardiomyopathy with a large thrombus in both ventricles was found to be the underlying cause of the liver injury. Treatment for the initially unrecognized heart failure rapidly restored liver function to normal. To our knowledge, this is the first reported case of severe acute liver failure due to an unrecognized anabolic steroid-induced cardiomyopathy. Awareness of this unique presentation will allow for prompt treatment of this potentially fatal cause of liver failure.
authors.affiliation: Department of Gastroenterology, Egas Moniz Hospital, Lisbon, Portugal. gastregas@hegasmoniz.min-saude.pt
authors.forename: Miguel
authors.initials: M
authors.lastname: Bispo
authors.forename: Ana
authors.initials: A
authors.lastname: Valente
authors.forename: Rosário
authors.initials: R
authors.lastname: Maldonado
authors.forename: Rui
authors.initials: R
authors.lastname: Palma
authors.forename: Helena
authors.initials: H
authors.lastname: Glória
authors.forename: João
authors.initials: J
authors.lastname: Nóbrega
authors.forename: Paula
authors.initials: P
authors.lastname: Alexandrino
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced / Q000150:complications; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology*; D008297:Male; D013256:Steroids / Q000009:adverse effects*; D014891:Weight Lifting
chemical_list: D045930:Anabolic Agents; D013256:Steroids