The effect of corticosteroid therapy on the development of liver cirrhosis: A clinical case

Drug-induced liver damage is a pressing issue in modern pharmacotherapy. The importance of studying this issue is especially high in the current conditions of polypharmacy, hypoor hyperdiagnosis of diseases with insufficiently justified prescription of drugs and their combinations. The article presents a clinical observation of a patient with developed decompensated liver cirrhosis after pulse therapy with methylprednisolone. The patient complained of severe pain and weakness in the lower extremities, was examined by a neurologist due to suspected multiple sclerosis – the diagnosis was not confirmed. Later, she was hospitalized for further diagnostics, an MRI study was performed with the detection of a few focal changes, which were interpreted as a demyelinating disease of the central nervous system, as a result of which pulse therapy with methylprednisolone was prescribed. She was discharged with positive dynamics, was observed on an outpatient basis in the multiple sclerosis office, did not lead a healthy lifestyle, there were episodes of drinking alcoholic beverages. Four months after the last hospitalization, the patient’s condition worsened, weakness and shortness of breath appeared. She was hospitalized and after a long diagnostic search, the final diagnosis was established: Unspecified liver cirrhosis. MELD = 22 points, Child-Pugh class B. The described clinical case is an example of the development of severe drug-induced liver injury induced by pulse therapy with methylprednisolone. Multiple sclerosis has a number of common features with other pathologies, therefore, to establish a diagnosis, it is necessary to conduct a detailed and comprehensive examination of the patient. It is important to exclude other possible diseases. Unreasonable and premature administration of corticosteroids can lead to drug-induced liver injury.