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Figure 1. A 69-year-old woman was treated for aplastic anemia with a high dose of androgens (2 mg of methenolone acetate per kilogram of body weight) for nearly two years, with an initially good response. Two months before her death immunosuppressive therapy with cyclosporine and methylprednisolone was initiated. Apart from a slightly elevated serum bilirubin level (2 mg per deciliter [34.2 mmol per liter]) and elevated serum lactate dehydrogenase concentration (450 U per liter) attributed to hemolysis, there was no biochemical evidence of liver disease. The patient died of refractory anemia and thrombocytopenia. At autopsy the liver was enlarged . . . [Full Text of this Article] |