Drug-induced liver injury associated with selective androgen receptor modulators in an adolescent patient

Selective androgenic receptor modulators (SARMs) have similar properties to anabolic steroids but bind to androgen receptors in a tissue-specific manner. Studies have investigated the benefits of SARMs in promoting bone and muscle growth while limiting the adverse effects of androgenic stimulation of other organs. However, an increase in the reported cases of hepatotoxicity in adults secondary to SARMs found in bodybuilding supplements has raised concerns about their safety. We report the first known adolescent case of SARMs-associated liver injury with a primarily hepatocellular pattern of injury. Previous reports in adults had shown a primarily cholestatic pattern of injury. Our case highlights, the variations in the phenotypic and histologic patterns of injury based on the amount and type of SARMs. The purpose of this case report is to shed light on the potential spectrum of liver injury related to SARMs use and continue to raise awareness of the associated health risks.