Max Saket Treated Drug Induced Liver Injury Due to Gym Supplements

A 26-years-old male, a gym instructor by profession, was admitted to Max Super Speciality Hospital, Saket, with a complaint of progressive jaundice. He had a history of jaundice for the last one month before admission. His evaluation outside the hospital showed worsening liver functions with deep jaundice, for which he was advised Liver Transplant. During hospitalization, his total Bilirubin increased to 42 mg/dL.

He had a history of intake of various intravenous and oral supplements, including the use of anabolic steroids over the last few months. On evaluation at Max Hospital, Saket, his viral markers were negative for Hepatitis B, C, A & E. The autoimmune markers were negative except for positive ANA.

In view of the diagnostic dilemma, Percutaneous Liver Biopsy was done, which showed features consistent with Drug Induced Liver Injury (DILI). He was treated with all supportive measures, including intravenous N-acetyl cysteine. Gradually he started to show improvement in INR and Liver and Renal Functions. Finally, he was discharged and was advised oral medications. Currently, he is doing well with total Bilirubin of 1.5 mg/dL along with normalization of AST/ALT & INR.

In conclusion, this case highlights the risk of liver toxicity with injudicious use of various supplements and anabolic steroids, which young people sometimes take, as part of the gym training. Key factors for the successful management of drug-induced liver injury includes: 

• Timely Intervention
• Correct Diagnosis
• Avoidance of Incriminating Drugs