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Updated: Aug 11, 2026
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Probable Enoxaparin-Induced Liver Injury in a Young Patient: A Case Report of a Diagnostic Challenge
Ikechukwu E Eze1, Sneha Adidam1, Domonick K Gordon1
1Internal Medicine, Howard University Hospital, Washington DC, USA.
Abstract:
Low molecular weight heparin (LMWH) is associated with elevated liver enzyme levels in a small percentage of patients. Elevations more than five times the upper limit of normal are uncommon and have been noted to primarily occur in patients receiving higher doses. The literature reports mild, primarily asymptomatic cases, with adverse effects at higher therapeutic doses. We report the case of a 27-year-old woman who developed drug-induced liver injury (DILI) while receiving enoxaparin during admission for a loculated pleural effusion secondary to pulmonary tuberculosis. The Roussel Uclaf Causality Assessment Method (RUCAM) score delineated enoxaparin as the likely cause.
Insights
Low molecular weight heparin (LMWH), like enoxaparin, can cause liver enzyme elevations. This case highlights drug-induced liver injury (DILI) from enoxaparin, even at therapeutic doses, emphasizing careful patient monitoring.
Area of Science:
- Hepatology
- Pharmacology
- Pulmonology
Background:
- Low molecular weight heparin (LMWH) use is common for anticoagulation.
- Elevated liver enzymes are a known, though uncommon, side effect of LMWH.
- Higher doses of LMWH are associated with a greater risk of liver enzyme elevation.
