Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange
ABSTRACT The proportion of non‐paracetamol drug‐induced liver injury (DILI) is increasing in Australia and other Western countries. Androgenic anabolic steroids (AAS) commonly cause a bland cholestasis that can persist for months despite withdrawal. A 35‐year‐old male presented with progressive pain...
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| Format: | Article |
| Language: | English |
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Wiley
2025-03-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70130 |
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| author | Samuel Wong Danny Con Avik Majumdar |
| author_facet | Samuel Wong Danny Con Avik Majumdar |
| author_sort | Samuel Wong |
| collection | DOAJ |
| description | ABSTRACT The proportion of non‐paracetamol drug‐induced liver injury (DILI) is increasing in Australia and other Western countries. Androgenic anabolic steroids (AAS) commonly cause a bland cholestasis that can persist for months despite withdrawal. A 35‐year‐old male presented with progressive painless jaundice associated with pruritus, nausea, loss of weight, dark urine, and pale stools. He had recently commenced AAS; DILI was suspected and confirmed on biopsy. His pruritus was refractory to medical therapy, and PLEX was commenced. He also developed renal failure from bile cast nephropathy (BCN) and required hemodialysis. At 10 weeks post‐discharge, his pruritus and jaundice were significantly improved, and his renal function had completely recovered. The case adds to the growing evidence that PLEX can be used safely and effectively to treat cholestatic pruritus and BCN. |
| format | Article |
| id | doaj-art-52fd12f9840f4a19bde03d835e97d18d |
| institution | DOAJ |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-52fd12f9840f4a19bde03d835e97d18d2025-08-20T02:41:55ZengWileyJGH Open2397-90702025-03-0193n/an/a10.1002/jgh3.70130Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma ExchangeSamuel Wong0Danny Con1Avik Majumdar2Liver Transplant Unit, Department of Gastroenterology Austin Health Heidelberg Victoria AustraliaLiver Transplant Unit, Department of Gastroenterology Austin Health Heidelberg Victoria AustraliaLiver Transplant Unit, Department of Gastroenterology Austin Health Heidelberg Victoria AustraliaABSTRACT The proportion of non‐paracetamol drug‐induced liver injury (DILI) is increasing in Australia and other Western countries. Androgenic anabolic steroids (AAS) commonly cause a bland cholestasis that can persist for months despite withdrawal. A 35‐year‐old male presented with progressive painless jaundice associated with pruritus, nausea, loss of weight, dark urine, and pale stools. He had recently commenced AAS; DILI was suspected and confirmed on biopsy. His pruritus was refractory to medical therapy, and PLEX was commenced. He also developed renal failure from bile cast nephropathy (BCN) and required hemodialysis. At 10 weeks post‐discharge, his pruritus and jaundice were significantly improved, and his renal function had completely recovered. The case adds to the growing evidence that PLEX can be used safely and effectively to treat cholestatic pruritus and BCN.https://doi.org/10.1002/jgh3.70130anabolic steroidsbile cast nephropathybland cholestasisdrug‐induced liver injuryplasma exchange |
| spellingShingle | Samuel Wong Danny Con Avik Majumdar Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange JGH Open anabolic steroids bile cast nephropathy bland cholestasis drug‐induced liver injury plasma exchange |
| title | Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange |
| title_full | Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange |
| title_fullStr | Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange |
| title_full_unstemmed | Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange |
| title_short | Rapid Resolution of Anabolic Androgenic Steroid‐Induced Refractory Pruritus and Bile Cast Nephropathy With Therapeutic Plasma Exchange |
| title_sort | rapid resolution of anabolic androgenic steroid induced refractory pruritus and bile cast nephropathy with therapeutic plasma exchange |
| topic | anabolic steroids bile cast nephropathy bland cholestasis drug‐induced liver injury plasma exchange |
| url | https://doi.org/10.1002/jgh3.70130 |
| work_keys_str_mv | AT samuelwong rapidresolutionofanabolicandrogenicsteroidinducedrefractorypruritusandbilecastnephropathywiththerapeuticplasmaexchange AT dannycon rapidresolutionofanabolicandrogenicsteroidinducedrefractorypruritusandbilecastnephropathywiththerapeuticplasmaexchange AT avikmajumdar rapidresolutionofanabolicandrogenicsteroidinducedrefractorypruritusandbilecastnephropathywiththerapeuticplasmaexchange |