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CASE REPORT
Methylprednisolone-induced acute liver injury in a patient treated for multiple sclerosis relapse
  1. Clement Bresteau1,
  2. Sophie Prevot2,
  3. Gabriel Perlemuter1,
  4. Cosmin Voican1
  1. 1Department of Hepato Gastroenterology and Nutirtion, Hopital Antoine-Beclere, Clamart, France
  2. 2Department of Pathology, Hopital Antoine-Beclere, Clamart, France
  1. Correspondence to Dr Cosmin Voican, cosmin.voican{at}aphp.fr

Summary

Drug-induced liver injury is the fourth most common cause of liver disease in industrialised countries. Methylprednisolone is often considered to be a treatment with a low hepatotoxicity. We report a case of methylprednisolone-induced liver injury in a 35-year-old woman. She was admitted to our department for acute liver injury 2 months after a treatment with high dose of methylprednisolone (1 g/day) for a multiple sclerosis relapse. No other cause of liver injury could be found (screening for hepatotropic viruses, autoimmune antibodies, ceruloplasmin, abdominal ultrasonography and liver biopsy). Liver function tests spontaneously improved and returned to normal range within 6 weeks. We also performed a brief review of the literature and identified 12 other cases of methylprednisolone-induced liver injury in patients treated for multiple sclerosis relapse. An immune rebound phenomenon could be responsible for rare but true hepatotoxicity of high-dose methylprednisolone therapy.

  • contraindications and precautions
  • hepatitis other
  • safety
  • multiple sclerosis

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Footnotes

  • Contributors CB: acquisition of data, manuscript writing, approval of final version. SP: analysis and interpretation of liver biopsy, approval of final version. GP: analysis and interpretation of data, approval of final version. CV: conception of the manuscript, analysis and interpretation of data, approval of final version.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Clement Bresteau: none declared. Sophie Prevot: none declared. Gabriel Perlemuter: reimbursement for conferences from Abbvie, Gilead, Janssen and Servier; speaking and consulting fees from Biocodex, Gilead, Pilèje and Servier; royalties from Elsevier/Masson, John Libbey and Solar. Cosmin Voican: reimbursement for conferences from Gilead, Biocodex, Aptalis Pharma, Abbvie and Janssen; speaking fees from Gilead. .

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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