Bispo M, Valente A, Maldonado R, Palma R, Glória H, Nóbrega J, Alexandrino P. Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder. World J Gastroenterol 2009; 15(23): 2920-2922 [PMID: 19533818 DOI: 10.3748/wjg.15.2920]
Corresponding Author of This Article
Miguel Bispo, MD, Department of Gastroenterology, Egas Moniz Hospital, Rua da Junqueira 126, 1349-019, Lisbon, Portugal. gastregas@hegasmoniz.min-saude.pt
Article-Type of This Article
Case Report
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World J Gastroenterol. Jun 21, 2009; 15(23): 2920-2922 Published online Jun 21, 2009. doi: 10.3748/wjg.15.2920
Anabolic steroid-induced cardiomyopathy underlying acute liver failure in a young bodybuilder
Miguel Bispo, Ana Valente, Rosário Maldonado, Rui Palma, Helena Glória, João Nóbrega, Paula Alexandrino
Miguel Bispo, Ana Valente, Rosário Maldonado, Rui Palma, Helena Glória, Paula Alexandrino, Intensive Care Unit of Gastroenterology and Hepatology, Santa Maria University Hospital, 1069-166 Lisbon, Portugal
Miguel Bispo, Department of Gastroenterology, Egas Moniz Hospital, 1349-019 Lisbon, Portugal
João Nóbrega, Coronary Care Unit, Santa Maria University Hospital, 1069-166 Lisbon, Portugal
Author contributions: Bispo M carried out the main role in reviewing the literature and writing the article. All authors contributed substantially to analyzing the patient’s data and revising the article.
Correspondence to: Miguel Bispo, MD, Department of Gastroenterology, Egas Moniz Hospital, Rua da Junqueira 126, 1349-019, Lisbon, Portugal. gastregas@hegasmoniz.min-saude.pt
Telephone: +351-919-002599
Fax: +351-213-624139
Received: March 15, 2009 Revised: May 11, 2009 Accepted: May 18, 2009 Published online: June 21, 2009
Abstract
Heart failure may lead to subclinical circulatory disturbances and remain an unrecognized cause of ischemic liver injury. We present the case of a previously healthy 40-year-old bodybuilder, referred to our Intensive-Care Unit of Hepatology for treatment of severe acute liver failure, with the suspicion of toxic hepatitis associated with anabolic steroid abuse. Despite the absence of symptoms and signs of congestive heart failure at admission, an anabolic steroid-induced dilated cardiomyopathy with a large thrombus in both ventricles was found to be the underlying cause of the liver injury. Treatment for the initially unrecognized heart failure rapidly restored liver function to normal. To our knowledge, this is the first reported case of severe acute liver failure due to an unrecognized anabolic steroid-induced cardiomyopathy. Awareness of this unique presentation will allow for prompt treatment of this potentially fatal cause of liver failure.
