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[Phenprocoumon-induced necrotizing hepatitis].

A R Schneider1, D Hartmann, J C Arnold

  • 1Medizinische Klinik C, Klinikum Ludwigshafen gGmbH. MedCLu@t-online.de

Deutsche Medizinische Wochenschrift (1946)
|May 22, 2001
PubMed
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Phenprocoumon, a blood thinner, can cause rare but severe liver injury (hepatitis). Promptly identifying and discontinuing this medication is crucial for patient recovery and preventing further liver damage.

Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Internal Medicine

Background:

  • Anticoagulation therapy with phenprocoumon is common for patients with prosthetic heart valves.
  • Unexplained hepatitis necessitates a thorough review of all medications, including anticoagulants.

Observation:

  • A 52-year-old female on phenprocoumon developed unexplained hepatitis.
  • Liver biopsies revealed necrotizing hepatocellular injury.
  • Initial drug-induced liver injury tests were negative, but a repeat lymphocyte transformation test for phenprocoumon became positive.

Findings:

  • Phenprocoumon withdrawal led to liver test normalization.
  • Resuming phenprocoumon caused a rapid increase in aminotransferase levels.
  • Phenprocoumon-associated necrotizing hepatitis was confirmed by clinical course, histology, and positive lymphocyte transformation test.

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Implications:

  • This case highlights the importance of detailed medication history in diagnosing cryptic hepatitis.
  • Physicians should consider coumarin derivatives like phenprocoumon as potential causes of severe liver injury.
  • Early recognition and drug withdrawal are key to managing drug-induced hepatitis.