Hepatoxicity SIG (Apr 11): Case-Based Discussion: 36 year-old male with prolonged cholestatic liver injury associated with renal impairment due to anabolic steroid use-Case-Based Disc: 36 year-old male with prolonged cholestatic liver injury associated with renal impairment due to anabolic steroid use

Case-Based Disc: 36 year-old male with prolonged cholestatic liver injury associated with renal impairment due to anabolic steroid use

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Video Transcription

Video Summary

The session features Dr. Andrew Stoltz presenting a case study focused on anabolic steroid-induced liver injury, particularly in a 35-year-old male who experienced cholestasis after using an anabolic steroid bought online. Dr. Stoltz, a professor of medicine at USC, shares his insights on the clinical presentation and potential treatments for such injuries. The discussion highlights the complex chemical structure of these steroids and their physiological effects, including the potential for severe liver and renal complications.<br /><br />Dr. David Kleiner contributes by reviewing the liver pathology, illustrating typical findings such as canalicular cholestasis and minimal inflammation associated with anabolic steroid use. The session also touches on the typical demographic profiles of affected patients—often young males with a history of seeking muscle enhancement and prior use of bodybuilding supplements, including oral anabolic steroid products.<br /><br />The presentation outlines key laboratory findings, including variations in liver enzymes and bilirubin levels over time, and discusses potential mechanisms of kidney injury linked to bile acid accumulation. The group also references a study on systemic IBAT inhibitors that might offer future therapeutic pathways for patients experiencing such renal complications.<br /><br />The presentation emphasizes the issue of mislabeling and adulteration of dietary supplements, with many containing unlisted or illegal anabolic steroids. This poses a significant challenge for clinicians trying to determine the true cause of injury. Audience members, including experts from Spain and India, discuss their experiences and potential treatments for similar cases, including corticosteroids and ursodiol, although the effectiveness of these treatments remains uncertain.

Keywords

anabolic steroids

liver injury

cholestasis

Dr. Andrew Stoltz

USC

renal complications

bodybuilding supplements

liver pathology

mislabeling

treatment