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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

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Methylprednisolone-induced toxic hepatitis.

Firdevs Topal¹, Ersan Ozaslan, Sabiye Akbulut

¹Department of Gastroenterology, Numune Education and Training Hospital, Ankara, Turkey. er72@hotmail.com

The Annals of Pharmacotherapy

|August 24, 2006

Summary

Methylprednisolone can cause rare but serious liver injury, presenting as toxic hepatitis. Discontinuing the steroid led to recovery, highlighting the need for vigilance in patients on this medication.

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Area of Science:

Hepatology
Clinical Pharmacology
Toxicology

Background:

Methylprednisolone, a corticosteroid, is rarely associated with hepatotoxicity.
This report details the third published case of methylprednisolone-induced toxic hepatitis as of April 2006.

Observation:

A 47-year-old woman presented with symptoms of liver dysfunction including elevated liver enzymes (ALT 2478 U/L, AST 1600 U/L) and jaundice.
She had recently completed a self-prescribed course of oral methylprednisolone for arm weakness.
Other potential causes of liver injury were ruled out, and topiramate, another medication, was not implicated.

Findings:

The patient exhibited mixed hepatocellular and cholestatic liver injury.
Discontinuation of methylprednisolone resulted in normalization of liver enzymes within 45 days without specific treatment.
Causality assessment using the Naranjo scale indicated probable relation to methylprednisolone.

Implications:

Hepatotoxicity from methylprednisolone, though uncommon, should be considered in patients presenting with elevated liver enzymes during steroid therapy.
This case underscores the importance of monitoring liver function in patients receiving methylprednisolone, especially with prolonged or high-dose use.