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Forensic Pathology Reviews pp 273–289Cite as

Long-Term Effects of Anabolic-Androgenic-Steroid Abuse

Morphological Findings Associated With Fatal Outcome

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Part of the book series: Forensic Pathology Reviews ((FPR,volume 2))

Abstract

The use of performance-enhancing drugs is an important and increasing phenomenon no longer limited only to elite athletes. Nowadays, people employ a broad variety of drugs in order to improve their athletic performance. Recent studies suggest that 3 to 12% of male adolescents and about 1 to 2% female adolescents use anabolic-androgenic-steroids (AAS) at some time during their lives. Serious alterations of different organ systems have been attributed to long-term use of these drugs. Adverse effects of AAS include myocardial hypertrophy and fibrosis, vascular disease and hepatic pathology such as hepatoma, peliosis hepatis, and cholestasis. Steroid-related abnormalities in lipid profiles with elevated low-density lipoprotein (LDL) cholesterol and depressed high-density lipoprotein (HDL) cholesterol, as well as hematological disorders, may increase the risk of cardiac infarction and stroke. Recently, a number of case reports of acute cardiac death associated with steroid abuse has appeared in the literature. The overwhelming majority of fatalities reported in the literature is associated with acute myocardial infarction (MI) with or without thrombotic occlusion of the coronary arteries. Steroid-associated cardiovascular lesions could be demonstrated in animal studies but there seem to exist no steroid-specific pathological findings in humans. Consequently, other possible reasons, apart from AAS use, responsible for structural organ changes have to be clarified by extensive morphological examination and toxicological analysis, including the circumstances of death as well as the individual’s previous medical history.

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Authors and Affiliations

  1. Institute of Legal Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany

    Roland Hausmann MD

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  1. Roland Hausmann MD
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  1. Institute of Legal Medicine, University of Hamburg, Hamburg, Germany

    Michael Tsokos MD

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© 2005 Humana Press Inc., Totowa, NJ

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Hausmann, R. (2005). Long-Term Effects of Anabolic-Androgenic-Steroid Abuse. In: Tsokos, M. (eds) Forensic Pathology Reviews. Forensic Pathology Reviews, vol 2. Humana Press. https://doi.org/10.1385/1-59259-872-2:273

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  • DOI: https://doi.org/10.1385/1-59259-872-2:273

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-415-9

  • Online ISBN: 978-1-59259-872-4

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