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Cholestatic liver reaction during heparin therapy
1Department of Medicine II, Sahlgrenska University Hospital, Göteborg, Sweden.
Journal of Internal Medicine
|May 1, 1991
Summary
Heparin can cause liver injury. This drug-induced liver injury presents as cholestatic liver enzyme abnormalities without jaundice and typically resolves after discontinuing the medication.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Drug-induced liver injury (DILI) is a significant clinical concern.
- Heparin is a widely used anticoagulant with a known safety profile.
- Cholestatic liver reactions are a less common manifestation of DILI.
Observation:
- Three patients developed asymptomatic cholestatic liver enzyme abnormalities.
- Abnormalities appeared after 10-28 days of heparin therapy.
- Jaundice was absent in all reported cases.
Findings:
- Heparin administration was associated with transient, cholestatic liver injury.
- Liver enzyme levels normalized within four months post-heparin cessation.
- This suggests a potential causal link between heparin and cholestatic liver reactions.
Implications:
- Heparin should be recognized as a potential cause of drug-induced cholestatic liver injury.
- Clinicians should consider heparin in the differential diagnosis of unexplained cholestatic liver abnormalities.
- Further investigation may be warranted to elucidate the mechanisms of heparin-induced hepatotoxicity.