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Jaundice associated with acenocoumarol exposure
E L de Bruyne1, D Jan Bac, R A de Man
1Ikazia Hospital, Department of Internal Medicine, Rotterdam, Netherlands.
The Netherlands Journal of Medicine
|July 4, 1998
Summary
Acenocoumarol, an anticoagulant, can cause liver damage (hepatotoxicity) in some patients. Promptly switching medication led to full recovery, suggesting a direct link between acenocoumarol and liver injury.
Area of Science:
- Pharmacology
- Hepatology
- Clinical Toxicology
Background:
- Deep venous thrombosis (DVT) is a serious condition requiring anticoagulant therapy.
- Acenocoumarol is a commonly prescribed oral anticoagulant.
- Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy.
Observation:
- A 69-year-old male patient developed cholestatic liver enzyme abnormalities after initiating acenocoumarol for DVT.
- Viral hepatitis and other common causes of liver injury were ruled out through serological testing.
- The patient presented with elevated liver enzymes indicative of hepatic dysfunction.
Findings:
- A presumptive diagnosis of acenocoumarol-induced hepatotoxicity was established.
- Discontinuation of acenocoumarol and substitution with low molecular weight heparin (LMWH) were implemented.
- Liver enzymes normalized within three weeks of drug withdrawal, and full recovery occurred within two months.
Implications:
- This case highlights the potential for acenocoumarol to cause drug-induced liver injury.
- It underscores the importance of monitoring liver function in patients receiving acenocoumarol.
- Early recognition and management of DILI can lead to favorable patient outcomes.