A new case report has linked the popular anabolic androgenic steroid (AAS) methandrostenolone to severe side effects including acute kidney injury, pancreatitis, and cholestatic jaundice. Methandrostenolone is widely available and has been used for years for both performance enhancement and aesthetic purposes. Consumers need to be aware of the significant risks associated with taking steroids, and that only mild doses can result in severe injuries and even death.
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Methandrostenolone Side Effects Case Report
The study, which was titled ‘Cholestatic jaundice, acute kidney injury and acute pancreatitis secondary to the recreational use of methandrostenolone: a case report,’ investigated the case of a 50-year-old Indian man who suffered a number of side effects including abdominal pain, anorexia and weight loss following an eight week cycle of methandrostenolone use. The patient’s subsequent test results were consistent with acute pancreatitis, intra-hepatic cholestasis, and acute tubular necrosis of the kidney.
The patient, who had tested positive for hepatitis C, presented with a two week history of severe abdominal pain. In the weeks leading up to the pain, the man experienced a gradual onset of anorexia and lost nearly 20 pounds, reporting symptoms of darkly colored urine and pale stools. Eight weeks prior to presentation, the patient had been taking 10 mg doses of methandrostenolone several times a day.
A computed tomography (CT) scan of the patient’s abdomen was performed, revealing mild fatty infiltration of the liver. A subsequent ultrasound of his abdomen showed mild hepatic enlargement and a small amount of sludge in his gallbladder. His renal parenchyma was echogenic and consistent with medical renal disease.
Within days of being admitted to the hospital, the patient began to suffer from extreme nausea, vomiting and abdominal pain. The case report’s authors identified the patient’s clinical picture as being consistent with acute pancreatitis. A CT scan of his abdomen showed a bulky pancreas with adjacent inflammatory fat stranding, indicating pancreatitis without a focal drainable abscess.
The patient went on to have a liver biopsy which revealed the following complications:
- grade 2 portal and lobular inflammation;
- stage 2-3 fibrosis consistent with hepatitis C viral infection;
- severe acute cholestasis consistent with anabolic steroid use;
- mild pericellular fibrosis consistent with alcohol abuse;
- acute tubular necrosis;
- renal failure
Discussion of Results
The case study’s patient revealed that he took methandrostenolone not for athletic performances purposes, but to “remain in shape.” Anabolic steroids like methandrostenolone are widely available to the general public over the Internet and at public gyms, as well as easily obtained illegally without a prescription. As a result, users are less likely to report taking these dangerous products to their physicians and physicians are less likely to consider the widespread use of AAS products in non-athlete patients.
The man investigated by the study represents the first case of a patient developing pancreatitis as a result of AAS use. Given that his liver biopsy was consistent with steroid use, it is highly likely that this was the main contributing factor in the pathogenesis of his pancreatitis. His hepatitis may have made him more prone to liver injury, but the relatively low elevation of transaminases suggests that the disease was quite mild and stable. Furthermore, the patient’s liver biopsy was consistent with steroid use and not hepatitis C infection. According to the study’s authors, “Whatever the exact mechanism, our patient’s history is most consistent with his AAS use as the main culprit in both his acute kidney injury and pancreatitis.”
Anabolic steroid use is rapidly expanding in the United states and around the world due to easy availability and the misconception that the products are safe. The risks and side effects associated with steroids are difficult to assess due to the unethical nature of administering the drugs. As a result, a significant increase in previously unreported adverse events are expected in the near future. Physicians need to be aware of the risks associated with steroids when administering drugs like methandrostenolone to patients, and to keep in mind that only mid doses of these products may lead to acute kidney injury, pancreatitis, and other extremely serious side effects.
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