{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T17:04:29Z","timestamp":1782579869148,"version":"3.54.5"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T00:00:00Z","timestamp":1525392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>High\u2010dose pulsed methylprednisolone\u2010related liver injury cases have been reported in the literature, but a prospective study in patients with multiple sclerosis (MS) has never been performed. The aim of this study was to evaluate the prevalence and severity of liver injury in patients with MS after pulsed methylprednisolone therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a prospective observational single\u2010center study on patients with MS treated with i.v. methylprednisolone 1,000\u00a0mg\/day for 5\u00a0days. We tested the liver functionality before and 2\u00a0weeks after the treatment. In case of severe liver injury, defined according to \u201cHy's law,\u201d a comprehensive hepatologic workup was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a 12\u2010month observation period, we collected data on 251 cycles of i.v. steroid treatment of 175 patients with MS. After excluding eight cycles presenting a basal alteration of the biochemical liver tests, we observed a prevalence of 8.6% of liver injury in MS patients treated with pulsed methylprednisolone for clinical and neuroradiological relapses. In 2.5% of the patients, the liver injury was severe according to Hy's law; after a comprehensive hepatologic workup, three of them received a diagnosis of drug\u2010induced liver injury and the other three of autoimmune hepatitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Liver injury after pulsed methylprednisolone therapy in patients with MS is not infrequent, and a close monitoring of aminotransferase level before treatment and 2\u00a0weeks later seems advisable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.968","type":"journal-article","created":{"date-parts":[[2018,5,5]],"date-time":"2018-05-05T04:10:22Z","timestamp":1525493422000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Liver injury after pulsed methylprednisolone therapy in multiple sclerosis patients"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-3948","authenticated-orcid":false,"given":"Viviana","family":"Nociti","sequence":"first","affiliation":[{"name":"Multiple Sclerosis Center Neuroscience Area, Neuroscience, Aging, Head and Neck and Orthopaedics Sciences Department Fondazione Policlinico Universitario Gemelli Catholic University of Sacred Heart  Rome Italy"},{"name":"Fondazione Don Gnocchi\u2010ONLUS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Biolato","sequence":"additional","affiliation":[{"name":"Liver Transplant Medicine Unit Gastroenterological Area, Gastroenterological and Endocrino\u2010Metabolical Sciences Department Fondazione Policlinico Universitario Gemelli Catholic University of Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"De Fino","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis 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