Abstract
Objectives
There is a paucity of literature about the methylprednisolone induced liver injury
in multiple sclerosis (MS) patients. In this study, we intended to investigate the
incidence, severity, and risk factors for liver injury in MS patients treated with
pulsed methylprednisolone therapy.
Methods
This is a prospective observational study on MS patients treated with methylprednisolone
pulses. All MS subjects with relapses who were referred to Sina Hospital between May
2020 to May 2021 were included in the study. They were evaluated for the demographic,
clinical characteristics, and liver function tests. Liver injury was diagnosed if
there was an elevation of serum aminotransferase levels above the upper normal limit
(45 IU/L).
Results
A total of 314 individuals participated in the study. The prevalence of liver injury
after treatment with pulsed methylprednisolone therapy was 2.86%. None of the cases
with liver injury were severe. Univariate regression analysis demonstrated that the
patients with liver injury had a significantly higher frequency of hyperlipidemia
(p: 0.002), alcohol abuse (p: 0.021), and non-alcoholic fatty liver disease (NAFLD)
(p: 0.005) compared to those without liver injury. Multivariate regression analysis
showed that hyperlipidemia (p: 0.04, odds ratio (OR): 6.31), and history of alcohol
abuse (p: 0.007, OR: 36.71) were significantly associated with liver injury.
Conclusions
Our study highlights the importance of a close follow-up of the liver function tests
in MS patients following pulsed methylprednisolone therapy, particularly in patients
with NAFLD, hyperlipidemia, and history of alcohol-abusing.
Keywords
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Article info
Publication history
Published online: June 15, 2022
Accepted:
June 13,
2022
Received in revised form:
May 30,
2022
Received:
January 23,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
