Liver Injury Induced by High-Dose Methylprednisolone Therapy: A Case Report and Brief Review of the Literature

Nejad, Esmaeil Mohammad; Jafari, Sirous; Mahmoodi, Mahmood; Begjani, Jamaloddin; Ehsani, Seyyedeh Roghayyeh; Rabirad, Narmela

doi:10.5812/kowsar.1735143x.707

Cited by 9 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pharmacological hepatotoxicity is usually idiosyncratic, and is based on individual and genetic susceptibility [1]. It is not related to drug dosage and imitates every possible presentation of acute or chronic hepatitis [1,6]. Latency period has been described from few days up to six months [1,2].…”

Section: Discussionmentioning

confidence: 99%

“…It is not related to drug dosage and imitates every possible presentation of acute or chronic hepatitis [1,6]. Latency period has been described from few days up to six months [1,2]. Prognosis varies from complete recovery to death [5].…”

Section: Discussionmentioning

confidence: 99%

“…Prognosis varies from complete recovery to death [5]. It is determined based on a strong suspicion of the clinician, an accurate anamnesis and the exclusion of other causes [1]. It is confirmed by: (1) the improvement of clinical and laboratory tests after the cessation of the administration of the drug and; (2) in selected cases, the relapse of abnormalities indicative of hepatotoxicity during subsequent exposures [2].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system [1]. Corticosteroids are the most used and highly effective treatment of MS relapses, as they target the autoimmune inflammatory response, and have proven to hasten recovery [2].…”

Section: Introductionmentioning

confidence: 99%

“…Regarding treatment options, there have been described patients who received dexamethasone in subsequent exacerbations without laboratory alterations or clinical manifestations [2], while others did not receive any treatment or remained asymptomatic in the follow-up period [2]. These different approaches are related to the absence of consensus regarding alternate treatment options for these patients [1]. Our patients did not experience additional exacerbations, but adrenocorticotropic hormone (ACTH), dexamethasone or plasma exchange would have been proposed as treatment options, according with the published data [3] and clinical findings.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Hepatotoxicity after high‐dose intravenous methylprednisolone in multiple sclerosis patients

Cruz

Acuña

Ros

et al. 2017

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageHepatotoxicity is a rare adverse event of methylprednisolone that should be considered in clinical practice. In patients at risk, we propose liver function surveillance, by measuring hepatic enzymes concentration 15–30 days after methylprednisolone administration. Additionally, we propose ACTH, dexamethasone, or plasma exchange as alternate treatment options for these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Hepatotoxicity after high‐dose intravenous methylprednisolone in multiple sclerosis patients

Cruz

Acuña

Ros

et al. 2017

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Natural Progression of Routine Laboratory Markers after Spinal Trauma: A Longitudinal, Multi-Cohort Study

Bourguignon

Tong

et al. 2021

Journal of Neurotrauma

View full text Add to dashboard Cite

Our objective was to track and quantify the natural course of serological markers over the 1st year following spinal cord injury. For that purpose, data on serological markers, demographics, and injury characteristics were extracted from medical records of a clinical trial (Sygen) and an ongoing observational cohort study (Murnau study). The primary outcomes were concentration/levels/amount of commonly collected serological markers at multiple time points. Two-way analysis of variance (ANOVA) and mixed-effects regression techniques were used to account for the longitudinal data and adjust for potential confounders. Trajectories of serological markers contained in both data sources were compared using the slope of progression. Our results show that, at baseline (£ 2 weeks post-injury), most serological markers were at pathological levels, but returned to normal values over the course of 6-12 months post-injury. The baseline levels and longitudinal trajectories were dependent on injury severity. More complete injuries were associated with more pathological values (e.g., hematocrit, ANOVA test; v 2 = 68.93, df = 3, adjusted p value <0.001, and v 2 = 73.80, df = 3, adjusted p value <0.001, in the Sygen and Murnau studies, respectively). Comparing the two databases revealed some differences in the serological markers, which are likely attributable to differences in study design, sample size, and standard of care. We conclude that because of trauma-induced physiological perturbations, serological markers undergo marked changes over the course of recovery, from initial pathological levels that normalize within a year. The findings from this study are important, as they provide a benchmark for clinical decision making and prospective clinical trials. All results can be interactively explored on the

show abstract

Natural Progression of Routine Laboratory Markers following Spinal Trauma: A Longitudinal, Multi-Cohort Study

Bourguignon

Tong

et al. 2021

Preprint

View full text Add to dashboard Cite

ObjectiveTo track and quantify the natural course of hematological markers over the first year following spinal cord injury.MethodsData on hematological markers, demographics, and injury characteristics were extracted from medical records of a clinical trial (Sygen) and an ongoing observational cohort study (Murnau Study). The primary outcomes were concentration/levels/amount of commonly collected hematological markers at multiple time-points. Two-way ANOVA and mixed-effects regression techniques were used to account for the longitudinal data and adjust for potential confounders. Trajectories of hematological markers contained in both data sources were compared using the slope of progression.ResultsAt baseline (≤ 2 weeks post-injury), most hematological markers were at pathological levels, but returned to normal values over the course of six to twelve months post-injury. The baseline levels and longitudinal trajectories were dependent on injury severity. More complete injuries were associated with more pathological values (e.g. hematocrit, ANOVA test; Chisq = 77.10, df = 3, adjusted p-value<0.001, and Chisq = 94.67, df = 3, adjusted p-value<0.001, in the Sygen and Murnau studies, respectively). Comparing the two databases revealed some differences in the hematological markers, which are likely attributable to differences in study design, sample size, and standard of care.ConclusionsDue to trauma-induced physiological perturbations, hematological markers undergo marked changes over the course of recovery, from initial pathological levels that normalize within a year. The findings from this study are important as they provide a benchmark for clinical decision making and prospective clinical trials. All results can be interactively explored on the Haemosurveillance website (https://jutzelec.shinyapps.io/Haemosurveillance/).Code availabilityhttps://github.com/jutzca/Systemic-effects-of-Spinal-Cord-Injury

show abstract

Liver Injury Induced by High-Dose Methylprednisolone Therapy: A Case Report and Brief Review of the Literature

Cited by 9 publications

References 14 publications

Hepatotoxicity after high‐dose intravenous methylprednisolone in multiple sclerosis patients

Hepatotoxicity after high‐dose intravenous methylprednisolone in multiple sclerosis patients

Natural Progression of Routine Laboratory Markers after Spinal Trauma: A Longitudinal, Multi-Cohort Study

Natural Progression of Routine Laboratory Markers following Spinal Trauma: A Longitudinal, Multi-Cohort Study

Contact Info

Product

Resources

About