Fatal hepatic coma complicating oxymetholone therapy in multiple myeloma

Aust N Z J Med. 1977 Feb;7(1):47-51.

Fatal hepatic coma complicating oxymetholone therapy in multiple myeloma.

Young GP, Bhathal PS, Sullivan JR, Wall AJ, Fone DJ, Hurley TH.

Two patients with multiple myeloma died in acute liver failure. Both had been
treated with the anabolic steroid oxymetholone and both subsequently developed
severe cholestatic hepatitis. In one the histological lesion progressed despite
cessation of oxymetholone therapy. Myeloma infiltration of the liver and peliosis
hepatis were not seen. As a fatal outcome from cholestatic hepatitis due to
oxymetholone is rare it is possible that an unknown potentiating factor is
present in multiple myeloma that can lead to a fatal outcome. If oxymetholone
therapy is to be used in such patients then close clinical and laboratory
assessment of liver function should be carried out in an attempt to prevent this
unusual and fatal complication.