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Clinical case - objective. 25 y . caucasian ♂ bodybuilder ( 188 cm , 92 kg ) 2006.04. starts AS according the scheme : 1 pill (5 mg) Nerobol (Methandienone) 3 time/day I week 4 time/day II week 5 time/day II I week

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Clinical case objective
Clinical case - objective

  • 25 y. caucasian ♂bodybuilder (188 cm, 92 kg)

  • 2006.04. starts AS according the scheme:

    • 1 pill (5 mg) Nerobol (Methandienone) 3 time/day I week

    • 4 time/day II week

    • 5 time/day III week

    • 6time/day IV week – and 1 amp Deca Durabolin (Nandrolone) each 5 daysi/m

  • Total per 2 monts 240 pills (1200 mg) Nerobol and 8 amp (400-800 mg ?) Deca Durabolin

  • Patient’s friend with the similar constitution used the same scheme – no symptoms


Clinical case first symptoms
Clinical case – first symptoms

  • No any symptoms for 2 months

  • After 2 months:

    • headache

    • loss of appetite

    • insomnia

    • disphagia

  • Loss of weight (15 kg during 5 weeks)

  • Increasing itch and jaundice


Clinical case outpatient treatment
Clinical case – outpatient treatment

  • Risk factor – physicians in family :

    • Infectionist – no infections

    • Reumatologist – no autoimmune disease

  • Medications:

    • loratadinum 10 mg p/o

    • ornitinum aspartate 9 g p/o

    • BZD


Clinical case outpatient examination
Clinical case – outpatient examination

  • Abdominal echoscopy - normal

  • TB: ~130→376

  • DB: ? →299

  • SGPT/ALT: 90

  • ALP: 215


Clinical case hospitalization
Clinical case – hospitalization

  • Arrival 06.16:

    • Significant jaundice

    • Ichterus

    • Scratches and excoriations everywhere

    • Encephalopaty


Clinical case inpatient examination
Clinical case – inpatient examination

  • TB 564→436→465→449→564→445

  • DB 460 →368→363→394→491→381

  • SGPT/ALT 75 →66→91→64→83→82

  • SGOT/ASAT286→106→67→54→59→62

  • ALP284 →228→234→193→232→184

  • CRPnot found

  • CBC normal levels

  • Total Ch 4,4 → 4,01

  • HDL Ch 0,35→ 0,08 (normal level >1)

  • LDL Ch 3,74 → 3,94

  • TG 3,49 → 3,82


Clinical case instrument al investigations
Clinical case – instrumental investigations

  • X-ray examination of Thorax – normal

  • Abdominal echoscopy - normal


Clinical case echocardiography
Clinical case – echocardiography

  • Decreased LVejection fraction 40% (normal value >55%), hypokinesis in LVinferior and inferolateral wall andinterventriculum septum bottom segments. Damaged diastolic function of LV


Clinical case treatment
Clinical case – treatment

  • Prednisolone 1mg/kg

  • Ornitinum aspartati 18 g p/o

  • Sylimarins

  • Neuroleptics

  • BZD

  • HBO

  • Hepatic Diet


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