Severe cholestasis with kidney failure from anabolic steroids in a body builder

Dtsch Med Wochenschr. 1999 Sep 10;124(36):1029-32.

[Severe cholestasis with kidney failure from anabolic steroids in a body builder]

[Article in German]

Habscheid W, Abele U, Dahm HH.

Medizinische Klinik, Paracelsus-Krankenhaus Ruit, Esslingen.

HISTORY AND ADMISSION FINDINGS: A 28-year-old body builder was admitted because
of jaundice. For 80 days, until 3 weeks before hospitalization, he had been
taking moderately high doses of anabolic steroids: metandienone (methandienone),
10-50 mg daily by mouth, and stanozolol, 50 mg intramuscularly every other day.
Physical examination was unremarkable except for yellow discoloration of the skin
and sclerae.

INVESTIGATIONS: Bilirubin concentration was raised to 4.5 mg/dl,
cholestasis enzymes were normal, while transaminase activities were raised. Liver
biopsy was compatible with cholestasis induced by anabolic steroids.

TREATMENT AND COURSE: Although the steroids had been discontinued, the patient's general
condition deteriorated over 7 weeks. Serum bilirubin rose up to a maximum of 77.9
mg/dl. In addition renal failure developed with a creatinine concentration of 4.2
mg/dl. The patient's state improved simultaneously with the administration of
ursodeoxycholic acid and the biochemical values gradually reached normal levels
after several weeks.

CONCLUSION: Anabolic steroids can cause severe cholestasis
and acute renal failure. In this case there was a notable temporal coincidence
between the administration of ursodeoxycholic acid and the marked clinical
improvement.