{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:17:00Z","timestamp":1789121820325,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":253,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Hepatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cholestatic liver injury from 17\u03b1\u2010alkylated anabolic\u2013androgenic steroids is established. We report a longitudinally documented case that emphasises phenotype definition and the limits of agent\u2010specific attribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 26\u2010year\u2010old man presented on Day 29 after self\u2010administering oral oxymetholone 50\u2009mg\/day with intramuscular testosterone enanthate 250\u2009mg\/week. Peak total bilirubin was 24.6\u2009mg\/dL (direct bilirubin 21.3\u2009mg\/dL), alanine aminotransferase 5.6\u2009\u00d7\u2009the upper limit of normal (ULN) and alkaline phosphatase 2.9\u2009\u00d7\u2009ULN; the R\u2010ratio was 1.91, indicating cholestatic injury. International normalised ratio (\u2264\u20091.04), albumin (\u2265\u20094.1\u2009g\/dL) and creatinine (0.8\u20130.9\u2009mg\/dL) remained preserved. Ultrasonography with hepatic Doppler showed a nondilated biliary tree (common bile duct 1\u20132\u2009mm), patent visualised vessels and no sonographic evidence of obstruction. The available viral, autoimmune, metabolic and haemolytic evaluation identified no alternative cause. Updated RUCAM assessment was limited by ursodeoxycholic acid use during dechallenge and incomplete molecular virology; concomitant testosterone and absent chemical verification of the products precluded definitive single\u2010agent attribution. Both agents were withdrawn on Day 30; ursodeoxycholic acid and antipruritic therapies were used as supportive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome<\/jats:title>\n                    <jats:p>Total bilirubin decreased by 69.1% by Day 57 and by 91.5% by Day 85. Pruritus resolved, daily function returned and renal and hepatic synthetic function remained preserved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This report provides granular 8\u2010week follow\u2010up of an established phenotype. The course supports oxymetholone as the principal suspect, but recovery cannot be attributed to supportive pharmacotherapy in this uncontrolled case.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crhe\/2519455","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T09:12:55Z","timestamp":1789117975000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oxymetholone\u2010Associated Cholestatic Drug\u2010Induced Liver Injury With Profound Hyperbilirubinaemia: A Longitudinal Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9721-6249","authenticated-orcid":false,"given":"Hatem Mousa","family":"Taha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0208-5481","authenticated-orcid":false,"given":"Baha\u2019 Husam","family":"Khalifa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4246-5570","authenticated-orcid":false,"given":"Majd Y.","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3972-9459","authenticated-orcid":false,"given":"Khaled Hatem","family":"Taha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0105-0"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.03.006"},{"key":"e_1_2_14_3_2","volume-title":"Hepatotoxicity: The Adverse Effects of Drugs and Other Chemicals on the Liver","author":"Zimmerman H. 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