RT Journal Article
T1 Liver injury after methylprednisolone pulses: A disputable cause of hepatotoxicity. A case series and literature review.
A1 Zoubek, Miguel Eugenio
A1 Pinazo-Bandera, Jose
A1 Ortega-Alonso, Aida
A1 Hernandez, Nelia
A1 Crespo, Javier
A1 Contreras, Fernando
A1 Medina-Caliz, Inmaculada
A1 Sanabria-Cabrera, Judith
A1 Sanjuan-Jimenez, Rocio
A1 Gonzalez-Jimenez, Andres
A1 Garcia-Cortes, Miren
A1 Lucena, M Isabel
A1 Andrade, Raul J
A1 Robles-Diaz, Mercedes
K1 AIH
K1 Graves' ophthalmopathy
K1 Methylprednisolone-induced liver injury
K1 multiple sclerosis
K1 steroid pulses
AB Corticosteroids are often empirically used to treat idiosyncratic hepatotoxicity with severe features. Interestingly, intravenous methylprednisolone (MP) is increasingly being recognized as being responsible for liver injury. We aimed to characterize MP-induced liver injury by analyzing demographical, clinical, laboratory and outcome data of three MP-induced hepatotoxicity cases and compared this information with that of previously published cases. Three females with multiple sclerosis (MS) were treated intravenously with MP, mean daily dose 767 mg. Liver damage occurred 2 to 6 weeks after exposure. Severity was mild to moderate. Two patients suffered positive rechallenge. We identified 50 published cases of MP hepatotoxicity. Most of these cases were female (86%) and main treatment indications were MS (29 cases) and Graves' ophthalmopathy (13 cases). Hepatocellular damage predominated and mean time to onset was 6 weeks. Four patients died and rechallenge occurred in 19 cases. MP pulses can induce severe liver injury, often with an autoimmune phenotype, particularly in patients with MS and Graves' ophthalmopathy. Consequently, these patient groups should have liver tests monitored when treated with MP to provide safer patient care.
PB SAGE
SN 2050-6406
YR 2019
FD 2019-02-17
LK http://hdl.handle.net/10668/14251
UL http://hdl.handle.net/10668/14251
LA en
NO Zoubek ME, Pinazo-Bandera J, Ortega-Alonso A, Hernández N, Crespo J, Contreras F, et al. Liver injury after methylprednisolone pulses: A disputable cause of hepatotoxicity. A case series and literature review. United European Gastroenterol J. 2019 Jul;7(6):825-837
DS RISalud
RD Apr 11, 2025