Year 2008 / Volume 100 / Number 11
Notas
Recurrent acute liver toxicity from intravenous methylprednisolone

pp. 720-723

Rivero Fernández, M. / Riesco, J. M. / Moreira, V. F. / Moreno, A. / López San Román, A. / Arranz, G. / Ruiz del Árbol, L.

Abstract
Adverse drug reactions (hepatotoxicity) are a frequent cause of acute liver injury with a wide clinical and histological spectrum. An early recognition of drug-related liver disease has been considered essential in clinical practice due to potential risks. In most cases exposure discontinuation improves the clinical picture.

Steroids are used in a variety of clinical settings. However, intravenous steroids have rarely been associated with hepatotoxicity. We report the case of a middle-aged woman with multiple sclerosis who received a bolus of methylprednisolone on three occasions for the management of relapsing disease, with the development of repeated episodes of elevated liver enzymes after corticoid administration. In the third episode a liver biopsy was performed, which showed acute hepatitis with bridging necrosis; such histological picture has not been described before in patients treated with intravenous steroids.
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Rivero Fernández, M. / Riesco, J. M. / Moreira, V. F. / Moreno, A. / López San Román, A. / Arranz, G. / Ruiz del Árbol, L.. Recurrent acute liver toxicity from intravenous methylprednisolone. 720-723


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