Methylprednisolone‐induced liver injury: Case report and literature review

Methylprednisolone-induced hepatotoxicity in a 16-year-old girl with multiple sclerosis

“…To date a limited number of cases of methylprednisolone-induced hepatotoxicity had been described 7 10–24. We report an idiosyncratic toxic hepatitis from high-dose methylprednisolone in a 16-year-old girl.…”

“…Liver injury caused by corticosteroids varied from asymptomatic hypertransaminasaemia to fulminant hepatic failure 10–24. Acute presentations include mild liver test abnormalities, cholestasis with pruritus, and sometimes acute liver failure mimicking aggressive conditions such as viral hepatitis.…”

“…However, perhaps not everyone knows the toxic damages to the liver due to methylprednisolone. Hepatotoxicity from HDCS had been described 7 10–24. This condition was related to immunomodulator drugs, autoimmune or viral agents, until recently when the relation between methylprednisolone therapy and hepatotoxicity had been proven 21 25.…”

Liver injury after pulsed methylprednisolone therapy in multiple sclerosis patients

“…Methylprednisolone's labelling information mentions transient increases in serum transaminases and hepatomegaly, but not clinically relevant hepatotoxicity; however, the literature review of high‐dose pulsed methylprednisolone (for any therapeutic indication) identified forty‐seven cases of liver injury, including one death (Carrier et al., ; Caster, Conforti, Viola, & Edwards, ; D'Agnolo & Drenth, ; Das et al., ; Davidov et al., ; Dourakis et al., ; Dumortier et al., ; Eguchi et al., ; Ferraro et al., ; Furutama et al., ; Gerolami et al., ; Grilli et al., ; Gutkowski et al., ; Hidalgo de la Cruz et al., ; Hofstee et al., ; Loraschi et al., ; Maàmouri et al., ; Marinó et al., ; Melamud et al., ; Moleti et al., ; Nanki et al., ; Oliveira et al., ; Reuβ et al., ; Rivero Fernández et al., ; Salvi et al., ; Takahashi et al., ; Topal et al., ; Weissel & Hauff, ).…”

“…High-dose pulsed methylprednisolone treatment has been also associated with liver injury. By reviewing the literature published in English, we found a total of forty-seven cases of methylprednisolonerelated liver injury, including patients treated for diseases other than MS (Carrier et al, 2013;D'Agnolo & Drenth, 2013;Das, Graham, & Rose, 2006;Davidov et al, 2016;Dourakis, Sevastianos, & Kaliopi, 2002;Dumortier et al, 2017;Eguchi et al, 2015;Ferraro et al, 2015;Furutama et al, 2011;Gerolami et al, 1997;Grilli, Galati, Petrosillo, Del Nonno, & Baiocchini, 2015;Gutkowski, Chwist, & Hartleb, 2011;Hidalgo de la Cruz et al, 2017;Hofstee, Nanayakkara, & Stehouwer, 2005;Loraschi et al, 2010;Maàmouri et al, 2009;Marinó et al, 2004;Melamud, Lurie, Goldin, Levi, & Esayag, 2014;Moleti et al, 2016;Nanki, Koike, & Miyasaka, 1999;Oliveira, Lopes, Cipriano, & Sofia, 2015;Reuβ, Retzlaff, Vogel, Franke, & Oschmann, 2007;Rivero Fernández et al, 2008;Salvi et al, 2004;Takahashi et al, 2008;Topal et al, 2006;Weissel & Hauff, 2000). The aim of this prospective study was to evaluate the prevalence, severity, and risk factors for liver injury in patients affected by MS treated with pulsed methylprednisolone.…”