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Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis

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Abstract

Even if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in the following few days. Although surgery and hyperbaric therapy were carried out, the man died. An autopsy with complete biological sampling for toxicological studies was performed. This case highlights the close relationship between AAS abuse and immunodeficiency and highlights it’s importance for further studies. However, it should be considered that of all the dangerous effects produced by AAS use, necrotizing fasciitis is not such an unusual consequence.

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Acknowledgements

We wish to thank the Scientific Bureau of the University of Catania for language support.

Author information

Author notes

  1. Giuseppe Bertozzi and Francesco Sessa contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Viale Pinto, 71122, Foggia, Italy

    Giuseppe Bertozzi, Francesco Sessa, Francesca Maglietta, Luigi Cipolloni & Pietrantonio Ricci

  2. Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Catania, Italy

    Monica Salerno & Cristoforo Pomara

  3. Forensic Toxicology Sections, “G. Tatarella” Hospital, Cerignola, Foggia, Italy

    Carmela Fiore & Palmira Fortarezza

  4. Institute of Legal Medicine, University degli studi Magna Graecia di Catanzaro, Catanzaro, Italy

    Pietrantonio Ricci

  5. Institute of Legal Medicine, Department of Surgical, University of Pisa, Pisa, Italy

    Emanuela Turillazzi

Authors
  1. Giuseppe Bertozzi
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  2. Francesco Sessa
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  3. Francesca Maglietta
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  4. Luigi Cipolloni
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  5. Monica Salerno
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  6. Carmela Fiore
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  7. Palmira Fortarezza
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  9. Emanuela Turillazzi
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  10. Cristoforo Pomara
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Contributions

GB, FS, FM, LC, MS, PR, ET, and CP participated actively to solve this case. GB, FS, CF, and PF carried out the experiments. GB, FS, CF, LC, PF, MS, ET, and CP contributed to the interpretation of the results. GB, FS, FM and CF wrote the manuscript in consultation with PR, ET and CP All authors provided critical feedback and helped shape the analysis and manuscript.

Corresponding author

Correspondence to Francesco Sessa.

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Conflict of interest

The authors hereby declare that they have no conflict of interest.

Ethical approval and consent to participate

All procedures performed in the study were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the relatives.

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The authors declare to have received written consent from relatives of all persons involved in this case report, to publish the article mentioned above in the Journal of Forensic Science, Medicine, and Pathology.

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Emanuela Turillazzi and Cristoforo Pomara shared last authorship

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Bertozzi, G., Sessa, F., Maglietta, F. et al. Immunodeficiency as a side effect of anabolic androgenic steroid abuse: a case of necrotizing myofasciitis. Forensic Sci Med Pathol 15, 616–621 (2019). https://doi.org/10.1007/s12024-019-00144-z

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  • DOI: https://doi.org/10.1007/s12024-019-00144-z

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