Anabolic steroids hepatitis

Reversible hepatotoxicity, in the form of abnormal liver function tests, led to the withdrawal of stanozolol in a patient with lipodermatosclerosis (54). Since some dermatologists continue to have faith in anabolic steroids in this condition, the patient was then given oxan-drolone, which is reputed to be less hepatotoxic. The hepatic problems did not recur, although several months later the patient developed a cardiomyopathy, which may have been coincidental. 

A large hepatic hematoma led to intra-abdominal hemorrhage in a 24-year-old man who for 2 years had taken two anabolic steroids as well as clomiphene and human chorionic gonadotropin (80). The authors obtained information from health clubs that users commonly took some 300 mg of nandrolone weekly, whereas the recommended dose was only 50 mg monthly. 

Schumacher J, Muller G, Klotz KF. Large hepatic hematoma and intraabdominal hemorrhage associated with abuse of anabolic steroids. N Engl J Med 1999 340(14) 1123 1. 

In athletes Use of anabolic steroids, (for example, nandrolone [nan DRO lone] or stanozolol [sta NO zo lol], by athletes can cause premature closing of the epiphysis of the long bones, which interrupts development. The high doses taken by these young athletes may result in hepatic abnormalities, increased aggression ( roid rage"), and psychotic episodes, as well as the other adverse effects described above. 

Echinacea 1. Hepatotoxic drugs, e.g. anabolic steroids 2. amiodarone 3. Methotrexate 4. Ketoconazole Risk of additive hepatotoxicity Use of echinacea for over 8 weeks can cause hepatotoxicity Be aware and use drugs with a potential to cause hypertonicity cautiously, monitoring clinically and biochemically for any early signs of hepatic dysfunction... 

C-17oc-substituted steroids impair bilirubin excretion into the hepatic canaliculi the block is biochemical not mechcinical. These include synthetic anabolic steroids and oestrogens used in oral contraceptives jaundice due to the latter is rare with the low dose formulations now preferred. 

Anabolic steroids hr order to improve anabolism and to stimulate hepatic regeneration, application of oxandrolone (80 mg/day over 4 or 5 weeks) may be considered. Good results have been achieved in alcoholic hepatitis following initial treatment. 

Although the horse appears to be refractory to the hepatic effects of most NSAIDs, their hepato-toxic potential should be considered, especially when they are concomitantly administered with other potentially hepatotoxic agents, such as fluoroquinolones, potentiated sulfonamides or anabolic steroids. In addition, many herbal preparations are potential hepatotoxic agents and clients may administer these compounds concurrently with prescribed NSAIDs without consulting their veterinarian. Echinacea and kava kava products, for example, are reported to be potential hepatotoxins and both are used in herbal remedy products that claim to produce calming or sedating effects in horses (Abebe 2002). 

An additional risk is as.sociatcd with self-injection of long-lasting anabolic steroid preparations. The risk of conttacliog hepatitis A. hepatitis C. and human immunodeficienc) vini> (HIV) is increa.scd if needles used for injecting steroids are shared.""... 

Rodway, R.G. and Galbraith, H. (1979) Effects of anabolic steroids on hepatic enzymes of amino acid catabolism. Hormone and Metabolic Research, 11, 489 190. 

C-17 anabolic steroids are a common cause of cholestasis and hepatic dy fur>ction. Detection of diolestasis... 

N. M. Martin, B. K. Abu Dayyeh and R. T. Chung, Anabolic steroid use causing recurrent hepatic adenomas and hemorrhage. World J. Gastroenterol, 2008, 14, 4573 575. 

Two further cases of hepatocellular carcinoma associated with anabolic steroid therapy have been reported. One was a child with Fanconi s anaemia, who was treated with anabolic steroids for 50 months (2 ). The other also occurred in a patient with Fanconi s anaemia following 4 years medication with androgenic, anabolic steroids (3 ). Examination of the livers of 2 patients with acquired aplastic anaemia who had been treated with similar compounds for 3 months prior to death revealed generalized parenchymal hyperplasia in one and widespread nodular hyperplasia in the other. Since 1971, 10 cases of hepatocellular carcinoma during medication with anabolic steroids have been reported in the literature. The prognosis is poor with a survival time of less than a year. The similar medical history indicates but does not prove a cause-effect relationship between disease and medication. The data must, however, be viewed alongside that pointing to hepatic tumours as complications of treatment with other types of steroids, notably the oral contraceptives. 

Most of the synthetic androgens and anabolic agents are 17-alkyl-substituted steroids. Administration of drugs with this structure is often associated with evidence of hepatic dysfunction. Hepatic dysfunction usually occurs early in the course of treatment, and the degree is proportionate to the dose. Bilirubin levels may increase until clinical jaundice is apparent. The cholestatic jaundice is reversible upon cessation of therapy, and permanent changes do not occur. In older males, prostatic hyperplasia may develop, causing urinary retention. 

Medicinal agents (such as contraceptives) may result in proliferations of the intima in the hepatic artery and its branches. In some cases, these arterial alterations were associated with thrombosis in the hepatic veins. Phar-macons can trigger three different forms of damage to the sinusoids (7.) dilation of the sinusoids (e.g. by contraceptives), (2.) perisinusoidal fibrosis (e.g. by azathio-prine, vitamin A and cytostatic agents), and (i.) peliosis hepatis (e. g. by contraceptives, anabolic and androgenic steroids, azathioprine, chenodesoxycholic acid). (13, 28, 130) (s. p. 398) (s. fig. 21.8)... 

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