Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis

Background and aims. Steroid-related hepatotoxicity has become one of the most relevant causes of drug induced liver cholestasis. some patients do not improve after standard medical treatment (SMT) and may therefore require other approaches, like extracorporeal liver support Material and methods. We report four cases of patients with pruritus,abnormal liver function tests and biopsy-proven anabolic steroid-indued cholestasis who were unresponsive to SMT. They underwent treatment with albumindiaysis (Molecular Adsorbent Recirculating system MARS (R)) A minimum of two MARS sesions were performed. Results. After MARS (R) procedure, patients sympotoms improved, as well as liver function tests thus avoiding liver transplantation. Conculusion. Albumin dialysis appears as a valuable therapeutic option for the management of anabolic steroid-induced cholestasis in patients that are un responsive to SMT.