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RESEARCH PRODUCT
Methylprednisolone-induced hepatotoxicity in a 16-year-old girl with multiple sclerosis.
Angelika MohnEleonora RotondoAlessandro GraziosiVincenzo Di Stefanosubject
paediatrics (drugs And Medicines)safetymedicine.medical_specialtyMultiple SclerosisAdolescentNauseaAnti-Inflammatory AgentsGastroenterologyMethylprednisoloneDiagnosis Differential03 medical and health sciencesLiver disease0302 clinical medicineInternal medicinemedicineHumansunwanted effects/adverse reactionsGlucocorticoidsmedicine.diagnostic_testAngioedemabusiness.industryMultiple sclerosisGeneral Medicinemedicine.diseaseMethylprednisolonePulse Therapy DrugLiver biopsyVomitingSettore MED/26 - Neurologia030211 gastroenterology & hepatologyFemaleDifferential diagnosismedicine.symptomChemical and Drug Induced Liver Injuryliver diseasebusiness030217 neurology & neurosurgerymedicine.drugFindings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effectdescription
Multiple sclerosis (MS) is a chronic inflammatory disease with demyelination of the central nervous system. High-dosage corticosteroids are the first-line therapy in the acute relapsing of MS. We report a case of severe high-dose methylprednisolone-induced acute hepatitis in a patient with a new diagnosis of MS. A 16-year-old girl was admitted for urticaria, angioedema, nausea and vomiting a month later she had been diagnosed with MS and treated with high-dosage methylprednisolone. Laboratory investigations showed hepatic insufficiency with grossly elevated liver enzymes. A liver biopsy showed focal centrilobular hepatocyte necrosis with interface hepatitis. Methylprednisolone-induced hepatotoxicity can confuse the clinical picture of patients with MS and complicate the differential diagnosis. We believe that each specialist should know it and monitor patients with MS taking high doses of methylprednisolone. As there is no screening model that predicts idiosyncratic hepatotoxicity, we promote screening for potential liver injury following pulse steroid therapy.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-12-01 | BMJ case reports |