title: Pathological changes in anabolic androgenic steroid users.
abstract: Several classes of recreational and prescription drugs have additional effects on the heart and vasculature, which may significantly contribute to morbidity and mortality in chronic users. The study presented herein focuses on pathological changes involving the heart possibly due to anabolic androgenic steroid use. The role these hormones may play in their occurrence of sudden cardiac death is also investigated. 98 medico-legal cases including 6 anabolic androgenic steroid users were retrospectively reviewed. Autopsies, histology, immunohistochemistry, biochemistry and toxicology were performed in all cases. Pathological changes consisted of various degrees of interstitial and perivascular fibrosis as well as fibroadipous metaplasia and perineural fibrosis within the myocardium of the left ventricle. Within the limits of the small number of investigated cases, our results appear to confirm former observations on this topic and suggest anabolic androgenic steroid's potential causative role in the pathogenesis of sudden cardiac deaths in chronic users.
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy.
authors.forename: Monia
authors.initials: M
authors.lastname: Lusetti
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Licata
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Legal Medicine, Modena, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Silingardi
authors.affiliation: Department of Diagnostic Medicine, Clinical and Public Health, University of Modena and Reggio Emilia, Section of Clinical Pathology, Modena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Reggiani Bonetti
authors.affiliation: University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects* / Q000032:analysis; D001284:Atrophy; D016022:Case-Control Studies; D005234:Fatty Liver / Q000473:pathology; D005355:Fibrosis; D049429:Forensic Pathology; D006197:Hair / Q000737:chemistry; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009206:Myocardium / Q000473:pathology; D032383:Myocytes, Cardiac / Q000473:pathology; D009336:Necrosis; D012189:Retrospective Studies; D013737:Testis / Q000473:pathology; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
chemical_list: D045930:Anabolic Agents; D008055:Lipids
keywords: Anabolic androgenic steroids; Autopsy; Histopathology; Sudden death; Toxicology