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Subacute liver failure induced by phenprocoumon treatment
1Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Germany. Mix.Heiko@gmx.de
Digestion
|November 5, 1999
Summary
A patient with Factor V Leiden mutation developed liver failure from phenprocoumon, a common oral anticoagulant. This case highlights the risk of drug-induced liver injury, necessitating liver transplantation.
Area of Science:
- Hepatology
- Hematology
- Pharmacology
Background:
- Deep venous thrombosis (DVT) is often managed with oral anticoagulants.
- Factor V Leiden mutation is a common inherited thrombophilia.
- Activated protein C resistance is associated with Factor V Leiden.
Observation:
- A 39-year-old woman with Factor V Leiden mutation and DVT developed jaundice after 4 months of oral anticoagulation.
- Subacute liver failure ensued, requiring an orthotopic liver transplant.
- Histopathology revealed extensive liver cell necrosis without significant inflammation.
Findings:
- Phenprocoumon-induced liver failure was diagnosed after excluding other causes.
- The patient recovered well 5 months post-transplantation with normal liver function.
Implications:
- Oral anticoagulants, like phenprocoumon, can cause serious hepatotoxicity.
- Therapeutic drug monitoring for oral anticoagulants should include assessment for liver injury.
- This case underscores the importance of considering drug-induced liver injury in patients on anticoagulation therapy.