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Órgano Oficial de la Asociación Mexicana de Hepatología

2016, Number 6

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Ann Hepatol 2016; 15 (6)

Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis

Díaz FC, Sáez-González E, Benlloch S, Álvarez-Sotomayor D, Conde I, Polo B, García M, Rodríguez M, Prieto M

Language: Spanish
References: 20
Page: 939-943
PDF size: 133.85 Kb.


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. Material and 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. Conclusion. Albumin dialysis appears as a valuable therapeutic option for the management of anabolic steroid-induced cholestasis in patients that are unresponsive to SMT.


REFERENCES

  1. Vilella AL, Limsuwat C, Williams DR, Seifert CF. Cholestatic jaundice as a result of combination designer supplement ingestion. Ann Pharmacother 2013; 47: e33.

  2. Herlitz LC, Markowitz GS, Farris AB, Schwimmer JA, Stokes MB, Kunis C, D’Agati V. Development of focal segmental glomerulosclerosis after anabolic steroid abuse. J Am Soc Nephrol 2010; 21: 163-72.

  3. Dodge T, Hoagland MF, Margaux F. The use of anabolic androgenic steroids and polypharmacy: a review of the literature. Drug Alcohol Depend 2011; 114: 100-9.

  4. Robles M, Gonzalez A, Medina I, Stephens C, Garcia M, Garcia B, Andrade R. Distinct phenotype of hepatotoxicity associated with illicit use of anabolic androgenic steroids. Aliment Pharmacol Ther 2015; 41: 116-25.

  5. Pares A, Herrera M, Aviles J, Sanz M, Mas A. Treatment of resistant pruritus from cholestasis with albumin dialysis: combined analysis of patients from three centers. J Hepatol 2010; 53: 307-12.

  6. Nin Chau T, Cheung WI, Ngan T, Lin J, Wing San Lee K, Tat Poon W, Li Tse M. Causality assessment of herb-induced liver injury using multidisciplinary approach and Roussel Uclaf Causality Assessment Method (RUCAM). Clin Toxicol (Phila) 2011; 49: 34-9.

  7. Kicman AT. Pharmacology of anabolic steroids. Br J Pharmacol 2008; 154: 502-21.

  8. El Sherrif Y, Potts JR, Howard MR, Barnardo A, Cairns S, Knisely AS, Verma S. Hepatotoxicity from anabolic androgenic steroids marketed as dietary supplements: contribution from ATP8B1/ABCB11 mutations? Liver Int 2013; 33: 1266-70.

  9. Hu J, Zhang Q, Ren X, Sun Z, Quan Q. Efficacy and safety of acetylcysteine in “non-acetaminophen” acute liver failure: A meta-analysis of prospective clinical trials. Clin Res Hepatol Gastroenterol 2015.

  10. Sturm N, Hilleret MN, Dreyfus T, Barnoud D, Leroy V, Zarski JP. Candesartan Cilexetil (Atacand) induced prolonged severe cholestasis improved by extracorporeal albumin dialysis. Gastroenterol Clin Biol 2005; 29: 1299-301.

  11. Prokurat S, Grenda R, Lipowski D, Kalicinski P, Migdal M. MARS procedure as a bridge to combined liver-kidney transplantation in severe chromium-copper acute intoxication: a paediatric case report. Liver 2002; 22(Suppl. 2): 76-7.

  12. Sen S, Ratnaraj N, Davies NA, Mookerjee RP, Cooper CE, Patsalos PN, Jalan R. Treatment of phenytoin toxicity by the molecular adsorbents recirculating system (MARS). Epilepsia 2003; 44: 265-7.

  13. Shi Y, He J, Chen S, Zhang L, Yang X, Wang Z, Wang M. MARS: optimistic therapy method in fulminant hepatic failure secondary to cytotoxic mushroom poisoning—a case report. Liver 2002; 22 (Suppl. 2): 78-80.

  14. Wittebole X, Hantson P. Use of the molecular adsorbent recirculating system (MARS) for the management of acute poisoning with or without liver failure. Clin Toxicol (Phila) 2011; 49: 782-93.

  15. Cisneros-Garza LE, Muñoz-Ramírez MR, Muñoz-Espinoza LE, Ruiz Velasco JA, Moreno-Alcántar R, Marín-López E, Méndez-Sánchez N. The molecular adsorbent recirculating system as a liver support system: summary of Mexican experience. Ann Hepatol 2014; 13: 240-7.

  16. Martinez B, Velasco MJ, Pozo A, Benlloch S, Berenguer J. Cholestatic injury by stanozolol intake. Rev Esp Enferm Dig 2006; 98: 219-20.

  17. Shah NL, Zacharias I, Khettry U, Afdhal N, Gordon FD. Methasteron- associated cholestatic liver injury: clinicopathologic findings in 5 cases. Clin Gastroenterol Hepatol 2008; 6: 255-8.

  18. Anand JS, Chodorowski Z, Hajduk A, Waldman W. Cholestasis induced by parabolan successfully treated with the molecular adsorbent recirculating system. ASAIO J 2006; 52: 117-8.

  19. Heidemann LA, Navarro VJ, Ahmad J, Hayashi PH, Stolz A, Kleiner DE, Fontana RJ. Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series. Dig Dis Sci 2016; 1-8.

  20. Hassanein TI, Tofteng F, Brown RS, Jr., McGuire B, Lynch P, Mehta R, Missing author, et al. Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis. Hepatology 2007; 46: 1853-62.




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