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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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