BigABill
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This post presents a case of a 16-year-old boy who developed collapsing glomerulopathy (CG) after using anabolic steroids for bodybuilding purposes. He presented with a 15-day history of vomiting and headache, along with elevated blood pressure (160/80 mmHg). The patient had been using a combination of dexona and dianabol (methandrostenolone) for general body development over the past three months.
Laboratory results showed:
- Serum creatinine: 2.27 mg/dl
- Urine protein to creatinine ratio: 6
- Proteinuria: 4.7 g over 24 hours
- Urine microscopy: 10-12 white blood cells, 5-40 red blood cells per high power field
Liver function tests (LFTs) were normal, and there was no evidence of jaundice or cholestasis. Tests for HIV, hepatitis B, and C were negative, and there were no biochemical indicators of thrombotic microangiopathy (TMA). An ultrasound of both kidneys revealed Grade II renal parenchymal changes.
Diagnosis and Findings:
The diagnosis of primary IgA nephropathy (IgAN) was confirmed through light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM), which revealed characteristic changes, including paramesangial electron-dense deposits and glomerular basement membrane (GBM) thinning and splitting. These findings pointed to primary IgAN rather than secondary causes.
Despite the patient having underlying IgAN, this case is notable because there are no previous reports of both CG and IgAN occurring concurrently in a young patient following anabolic steroid use. The patient’s liver function tests were normal, making drug-induced liver dysfunction as a cause of IgAN unlikely. Importantly, there was no evidence of TMA, severe ischemic changes, or other viral infections that could have contributed to the development of CG.
Conclusion:
While not all patients with IgAN who use anabolic steroids develop CG, the temporal relationship between steroid use and the development of CG in this patient strongly suggests that anabolic steroids may have acted as a precipitating factor. This case highlights the potential risks of short-term anabolic steroid abuse, especially in individuals with underlying kidney conditions like IgAN.
This case serves as a reminder of the potential renal complications associated with anabolic steroid use, even in relatively healthy individuals. It is essential for bodybuilders and those considering anabolic steroid use to be aware of these risks, particularly if they have pre-existing kidney conditions.
If anyone has similar experiences or additional insights on the impact of anabolic steroids on kidney health, particularly in individuals with underlying conditions like IgAN, please share your knowledge or personal stories.
Laboratory results showed:
- Serum creatinine: 2.27 mg/dl
- Urine protein to creatinine ratio: 6
- Proteinuria: 4.7 g over 24 hours
- Urine microscopy: 10-12 white blood cells, 5-40 red blood cells per high power field
Liver function tests (LFTs) were normal, and there was no evidence of jaundice or cholestasis. Tests for HIV, hepatitis B, and C were negative, and there were no biochemical indicators of thrombotic microangiopathy (TMA). An ultrasound of both kidneys revealed Grade II renal parenchymal changes.
Diagnosis and Findings:
The diagnosis of primary IgA nephropathy (IgAN) was confirmed through light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM), which revealed characteristic changes, including paramesangial electron-dense deposits and glomerular basement membrane (GBM) thinning and splitting. These findings pointed to primary IgAN rather than secondary causes.
Despite the patient having underlying IgAN, this case is notable because there are no previous reports of both CG and IgAN occurring concurrently in a young patient following anabolic steroid use. The patient’s liver function tests were normal, making drug-induced liver dysfunction as a cause of IgAN unlikely. Importantly, there was no evidence of TMA, severe ischemic changes, or other viral infections that could have contributed to the development of CG.
Conclusion:
While not all patients with IgAN who use anabolic steroids develop CG, the temporal relationship between steroid use and the development of CG in this patient strongly suggests that anabolic steroids may have acted as a precipitating factor. This case highlights the potential risks of short-term anabolic steroid abuse, especially in individuals with underlying kidney conditions like IgAN.
This case serves as a reminder of the potential renal complications associated with anabolic steroid use, even in relatively healthy individuals. It is essential for bodybuilders and those considering anabolic steroid use to be aware of these risks, particularly if they have pre-existing kidney conditions.
If anyone has similar experiences or additional insights on the impact of anabolic steroids on kidney health, particularly in individuals with underlying conditions like IgAN, please share your knowledge or personal stories.
