FATAL OUTCOME OF A PATIENT WITH SEVERE APLASTIC-ANEMIA AFTER TREATMENT WITH METENOLONE ACETATE

A 75-year-old man suffering from severe aplastic anemia was treated fi rst with cyclosporin A, then with stereoid pulse therapy, and subseque ntly with metenolone acetate. Marked elevation of transaminases was de tected following initiation of treatment with metenolone acetate. This was followed by hepatic failure and death. Histopathological findings in autopsy specimens were compatible with the diagnosis of drug-induc ed liver impairment, for which metenolone acetate was considered the m ost likely causative agent. Liver impairment as a side effect of the u se of this drug has been thought to be mild, reversible and rather inf requent. However, as demonstrated in the case described here, it is ap parent that extreme caution should be exercised when using this drug i n debilitated patients.