Drug-induced liver injury from high-dose intravenous methylprednisolone: A rare but known adverse effect

Table 1 Complete metabolic panel showing elevated liver enzymes the following day after high-dose methylprednisolone

Variable	Patient values	Normal range
AST	224	15-41 U/L
Alkaline phosphatase	111	32-91 U/L
Total bilirubin	0.8	0.3-1.0 mg/dL
Calcium	9.1	8.6-10.4 mg/dL
Total protein	6.4	5.8-8.2 g/dL
Albumin	4.0	3.5-5.1 g/dL
Glucose, blood	211	70-139 mg/dL
BUN	16	6-20 mg/dL
Creatinine	0.60	0.44-1.03 mg/dL
BUN/creatinine ratio	24.2	10.0-20.0 mgUN/mgCR
Sodium, blood	141	136-145 mmol/L
Potassium, blood	4.4	3.5-5.1 mmol/L
Chloride, blood	107	98-107 mmol/L
Osmolality, calculated	298	275-295 mOsm/kg
CO2	25	22-32 mmol/L
Anion gap	9	4-15 mmol/L
ALT	233	7-52 U/L
CKD-EPI eGFR	100	> 59 mL/minute/1.73 m2

AST: Aspartate aminotransferase; BUN: Blood urea nitrogen; UN: Urea nitrogen; CR: Creatinine; ALT: Alanine aminotransferase; CKD-EPI eGFR: Chronic kidney disease epidemiology collaboration equation for estimating glomerular filtration rate.