Methylprednisolone-induced Toxic Hepatitis After Intravenous Pulsed Therapy for Multiple Sclerosis Relapses.

Abstract

High-dose, intravenous methylprednisolone (MP) is the only recommended first-line treatment for multiple sclerosis relapses. However, there are increasing reports on liver toxicity induced by this treatment regimen. We report of 4 multiple sclerosis patients with no history of viral/metabolic liver disorders or alcohol/hepatotoxic drug intake, who developed hypertransaminasaemia following intravenous MP. In 2 of the patients, liver biopsy showed periportal fibrosis, piecemeal necrosis, and inflammatory cell infiltrates. A rechallenge test confirmed a causal association in 1 case. MP-induced liver toxicity may be more frequent than commonly thought and it is important to report this adverse reaction, which is potentially lethal, and to raise awareness on the potential hepatotoxicity of corticosteroid pulses.

• Authors: Diana Ferraro, Vincenzo G Mirante, Luisa Losi, Erica Villa, Anna M Simone, Francesca Vitetta, Lucia Federzoni, Paolo F Nichelli, Patrizia Sola
• Journal: The neurologist (Neurologist) Vol. 19 Issue 6 Pg. 153-4 (Jun 2015) ISSN: 2331-2637 [Electronic] United States
• PMID: 26075468 (Publication Type: Case Reports, Journal Article)

Chemical References

• Methylprednisolone

Topics

• Administration, Intravenous
• Adult
• Chemical and Drug Induced Liver Injury (diagnosis)
• Female
• Humans
• Methylprednisolone (administration & dosage, adverse effects)
• Middle Aged
• Multiple Sclerosis, Relapsing-Remitting (drug therapy)
• Pulse Therapy, Drug
• Young Adult