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Intrahepatic Cholestasis with Fatal Termination Following Norethandrolone Therapy

Enid F. Gilbert, MD; A. Q. DaSilva, MD; Dan M. Queen, MD
JAMA. 1963;185(6):538-539. doi:10.1001/jama.1963.03060060136026.
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THE ANABOLIC STEROIDS which produce nitrogen retention with minimal androgenic activity are receiving wide application in the treatment of cachexia associated with chronic diseases, burns, osteoporosis, and fractures and as an adjunct in prolonged steroid therapy.1 These agents which include norethandrolone, methyltestosterone, and methandrostenolone may produce alterations in liver function2-6 and may cause an intrahepatic cholestasis with obstruction and jaundice. This paper presents a case of intrahepatic biliary obstruction due to cholestasis after prolonged administration of norethandrolone.

Report of a Case  A 74-year-old male was treated with norethandrolone in a dosage of 30 mg per day, after a hemiplegia and x-ray evidence of osteoporosis. Therapy was instituted on June 2, 1960. The patient did well until Nov 18, at which time he was noted to be severely icteric. A total serum bilirubin level of 32.4 mg/100 cc with a direct bilirubin of 21.8 mg/100 cc was found at


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