P81 | Jaundice at the gym, a case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Synthetic anabolic steroids have gained extensive utilization for augmenting exercise and athletic performance, demonstrating the potential to induce cholestatic liver injury. Conversely, phytoecdysteroids are traditionally presumed to lack this hepatotoxicity. Is this always true?Case report: An athletic 22 y.o. male, who has been engaging in anabolic supplementation with phytoecdysteroids for more than one month, manifested symptoms including pruritus, dark urine, and jaundice, necessitating clinical assessment. Laboratory testing revealed elevated levels of bilirubin, predominantly in the direct fraction, as well as increased levels of ALP, AST, ALT, and GGT. Abdominal magnetic resonance imaging (MRI) was conducted, revealing a reduction in the diameter of the common bile duct. Subsequent endoscopic retrograde cholangiopancreatography did not identify any pathological findings. The high bilirubin levels necessitated repeated sessions of apheresis. Intravenous hydration and ursodesoxycholic acid have been administered with benefit. The investigation into secondary causes of hepatobiliary inflammation has been initiated, ruling out infectious etiology (negative for HBV, HCV, CMV, EBV, WW) or autoimmune diseases (negative for ANA, AMA, ASMA, Anti-LKM, ANCA, ENA), confirming hepato-cholangitis as a result of anabolic steroid use.Conclusions: Notwithstanding their favorable characterization in the literature, prudence is imperative when dealing with dietary supplements containing phytoecdysteroids, given the potential risk of inducing severe hepato-cholangitis.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Pharmacology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4413656057