Schwere Cholestase mit Nierenversagen durch Anabolika bei einem BodybuilderAnabolic steroid jaundice Forum Videos Galerie my. Wer die Werbung nicht mag, der kann sie in seinen Persönl. A case of jaundice and IgA nephropathy as a consequence of use of a muscle enhancing OTC supplement that was advertised as innocuous with no hormonal activity is described. IgA nephropathy tseroid not jayndice described previously in association with the use anabolic steroid jaundice testosterone. The case highlights that, besides testosteron kur vom urologen, the misrepresentation of chemicals present in OTC medications and supplements can create confusion and a false sense of security with their use.
Portal Forum Videos Galerie my. Wer die Werbung nicht mag, der kann sie in seinen Persönl. A case of jaundice and IgA nephropathy as a consequence of use of a muscle enhancing OTC supplement that was advertised as innocuous with no hormonal activity is described.
IgA nephropathy has not been described previously in association with the use of testosterone. The case highlights that, besides adulteration, the misrepresentation of chemicals present in OTC medications and supplements can create confusion and a false sense of security with their use.
Am J Gastroenterol ; The use of testosterone has been reported to produce cholestatic jaundice that spontaneously resolves within a few weeks of its onset 3. Herein is reported a case of jaundice and IgA nephropathy in an individual who was using a muscle enhancing OTC supplement that was advertised as having no hormonal ingredients.
Two months before the onset of his clinical symptoms, he had started using an OTC nutritional supplement for bodybuilders named anabolic extreme superdrol having methasteron as its active ingredient. He consumed 72 mg pills of superdrol, starting at one tablet daily for 2 wk followed by two tablets daily. He did not exceed the maximal suggested dose of pills 10 mg each that was recommended over a 6-wk period.
He stopped using superdrol with the onset of diffuse skin itching. He did not report any history of alcohol, recreational drugs, or tobacco use. There was no family history of liver disease. He did not have any drug allergies.
On physical examination, his vital signs were stable. He was deeply icteric with several scratch marks noted throughout the trunk and lower extremities. He was overweight with a BMI of At presentation, labs revealed a total bilirubin of Smooth muscle, antinuclear, myeloperoxidase, and LKM antibodies were negative.
A urinalysis did not reveal proteinuria or hematuria. The rest of his lab reports are summarized in Table. The patient was hospitalized for one day and discharged on oral ursodeoxycholic acid at mg twice daily and hydroxyzine at 25 mg three times daily to be used as needed for pruritus.
Two weeks later, he presented to the hospital because of vomiting and unrelenting skin itching. A liver biopsy showed features of marked intrahepatic cholestasis, mild portal inflammation consisting predominantly of lymphocytes, foci of lobular inflammation with balloon degeneration, mild Kupffer cell iron deposition and pericellular fibrosis.
There was no evidence of granulomas, peliosis, hepatic rosettes, portal fibrosis, or bile duct injury Fig. The hepatic iron index was 1. The gallbladder and bile duct were normal. The kidneys were slightly echogenic. A kidney biopsy showed interstitial edema containing a mild lymphohistiocytic infiltrate with numerous esoinophils. After 1 wk of hospitalization, the patient was discharged and readmitted 4 days later because of rectal bleeding and a hemoglobin level of 7.
The upper and lower gastrointestinal endoscopies did not reveal any varices. After receiving 2 units of packed red blood cells, his hemoglobin increased to 9. Two wk later, he followed up in the outpatient clinic, feeling better without any itching and near-normalization of his lab reports including both kidney and liver function. It is a conglomerate of eight products including superdrol and is available OTC as well as on the Internet.
All products are advertised to have varied affects on enhancing muscle strength. Anabolic extreme-superdrol, which was self-administered by the reported patient, has an active ingredient methasteron.
This product is advertised on the Internet as "definitely not a pro-hormone … it is a very active form of a designer supplement that is also highly anabolic … It will give you dramatic and immediate gain in size and strength, significantly improve endurance and has zero estrogen conversion" 4. There is no mention of side effects associated with superdrol either on the bottle label or on the Internet.
Based on telephone contact and Internet search, no reports of anabolic extreme induced toxicity could be found reported to the FDA. Individuals who seek CAM are either frustrated with traditional medicine or believe that CAM is innocuous and experiment with such agents in order to find out if they are right for them 6.
In order to achieve a particular body image, professionals and amateurs both have been widely reported to use AAS through the black market, health clubs, or Internet 7. AAS are derivatives of testosterone that can impair hepatic excretory functions by interfering with both the bile salt-dependent and bile salt-independent bile flow. Although AAS with predominant anabolic or androgenic affects have been described, there is an overlap between various activities of AAS 7.
The hepatotoxicity of AAS typically manifests as cholestatic jaundice, although a predominant hepatocellular toxicity 3 and peliosis hepatic have been also published 8. Liver biopsy features of AAS-associated jaundice typically show a normal hepatic parenchyma and marked intrahepatic cholestasis as seen in the described patient. Occasionally, mild hepatic parenchymal injury with sinusoidal acidophilic bodies and small foci of necrosis are also noted.
The prognosis for complete recovery from AAS-induced jaundice is excellent for anicteric patients and hepatic function promptly returns to normal on cessation of the drug. The resolution of jaundice occurs in icteric patients as well although it can take up to several months 9— Because of ongoing worsening of renal function that did not correct with intravenous hydration, the reported patient underwent a kidney biopsy that showed IgA nephropathy and interstitial nephritis.
On a Medline search, no reports of testosterone-induced intersitital nephritis or IgA nephropathy were found. IgA nephropathy is a kidney disorder characterized by a predominant IgA deposition in the glomerular mesangium.
Interestingly, IgA nephropathy has been associated with many liver diseases including alcoholic liver disease, viral hepatitis A, B, and C, alphaantitrypsin deficiency, autoimmune hepatitis, Alagille syndrome, as well as liver cirrhosis 2, 12, The reported patient was not rechallenged with superdrol because it could not be ethically justified.
Although, the occurrence of IgA nephropathy with the use of superdrol may be purely coincidental, the temporal association of the onset of jaundice and IgA nephropathy with the consumption of superdrol implies that the association is more than casual. Because there have been no reports of renal toxicity associated with the use of testosterone, we speculate that IgA nephropathy most likely occurred secondary to hepatic dysfunction and resultant hypergammglobulinemia induced by superdrol.
Liver and kidney diseases. Clin Liver Dis ;6: Endo Y, Kanbayashi H. Etiology of IgA nephropathy syndrome. J Clin Gastroenterol ; When trust in doctors erodes, other treatment fill the void. N Y Times ;53, Alternative medicine or "alternative" patients: A qualitative study of patient-oriented decision-making processes with respect to complementary and alternative medicine.
Med Decis Making ; Adverse effects of anabolic steroids in athletes. Hepatic effects of 17 alpha-alkylated anaboli-androgenic steroids. Semin Liver Dis ;7: A review with four additional case reports. J Okla State Med Assoc ; Alphaantitrypsin deficiency associated with hepatic cirrhosis and IgA nephritis. IgA nephritis in a patient with Alagille syndrome and a transplanted liver.
Thieme E-Journals - DMW - Deutsche Medizinische Wochenschrift / Abstract
ISAACS, B., J. G. MCARTHUR, and R. M. TAYLOR: Jaundice in relation to LEEvy, and R. M. DowBEN: Effect of anabolic steroids on liver function tests and . Protein Metabolism. Influence of growth hormone, anabolic steroids, and nutrition in health and disease, S. – Int. Symp.  BAINEs, G. F.: Jaundice in. März Anabolic steroids as a cause of severe cholestasis and renal failure in a body A year-old body builder was admitted because of jaundice.