guidebook. - Fanconi Anemia Research Fund

Chapter 4: Gastrointestinal Problems in FA
89
Androgens also damage hepatocytes nonspecifically.
This may be manifest as cholestatic jaundice or hypertransaminasemia.
Cessation of androgen therapy will
usually lead to complete resolution. There are case
reports of hepatic cirrhosis in patients on continued
androgen therapy. 13 If resolution of enzyme elevation
does not occur after androgen withdrawal, biopsy is
indicated.
Figure 1: Management of potential hepatic complications in the FA
patient on androgen therapy
US every 6 months
AND
AST/ALT every 3 months
Increased ALT/AST
OR
Cholestatic jaundice
Mass on US
INR, PTT, hepatic US
AND
Withdraw or reduce androgens
Normal studies
4 weeks
Labs remain
abnormal
Withdraw or
reduce androgens
Mass remains
on US
3 months
Resolution
of mass
No further
therapy
Liver biopsy
and further
evaluation
>5 cm