title: Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis.
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.
  
  
  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.
  
  
  CONCLUSIONS
  Albumin dialysis appears as a valuable therapeutic option for the management of anabolic steroid-induced cholestasis in patients that are unresponsive to SMT.
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Francia C
authors.initials: FC
authors.lastname: Díaz
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: Sáez-González
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Benlloch
authors.affiliation: * Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Álvarez-Sotomayor
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Conde
authors.affiliation: Department of Paediatric Gastroenterology. La Fe University Hospital, Valencia. Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Polo
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: María
authors.initials: M
authors.lastname: García
authors.affiliation: Department of Digestive Diseases. Liver Unit. Hospital General Universitario Alicante. Spain.
authors.forename: María
authors.initials: M
authors.lastname: Rodríguez
authors.affiliation: Department of Gastroenterology, Hepatology and Liver Transplantation Unit. La Fe University Hospital, Valencia. Spain.
authors.forename: Martín
authors.initials: M
authors.lastname: Prieto
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects*; D000732:Androstanols / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008567:Membranes, Artificial; D011485:Protein Binding; D011537:Pruritus / Q000139:chemically induced; D020127:Recovery of Function; D012709:Serum Albumin / Q000008:administration & dosage*; D000075462:Serum Albumin, Human; D016060:Sorption Detoxification / Q000295:instrumentation / Q000379:methods*; D045165:Testosterone Congeners / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C422455:ALB protein, human; D045930:Anabolic Agents; D000732:Androstanols; D008567:Membranes, Artificial; D012709:Serum Albumin; D045165:Testosterone Congeners; C002976:epitiostanol; D000075462:Serum Albumin, Human