TY - JOUR
T1 - Low molecular weight heparin as cause of liver injury
T2 - Case report and literature review
AU - Leo, M.
AU - Ponziani, F. R.
AU - Nesci, A.
AU - Santoliquido, A.
AU - Vecchio, F. M.
AU - Francalanci, P.
AU - Pompili, M.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Low molecular weight heparins (LMWH) are a class of drugs including various molecules that inhibit predominantly the factor V of coagulation and are used in a wide range of clinical settings for the management of venous thromboembolism and acute coronary syndrome. Despite LMWH are considered safe and associated with a lower incidence of side effects compared to unfractioned heparin, it is worth considering that the use of LWMH can be associated with complications. Some of these, such as bleeding and thrombocytopenia, are well-known, whereas other ones are often underestimated leading to a diagnostic delay. In this case report, we describe a case of a 73-years-old man who recently started nadroparin for deep vein thrombosis presenting with acute hepatitis. The diagnostic workup of drug-induced liver injury (Dili) requires the exclusion of other causative agents and temporal association between the initiation of the culprit drug and hyper aminotransferasemia. This clinical case analyzes how to deal with a suspicion of Dili and consider LWMH as a potential cause of Dili, which requires a modification of the anticoagulant treatment.
AB - Low molecular weight heparins (LMWH) are a class of drugs including various molecules that inhibit predominantly the factor V of coagulation and are used in a wide range of clinical settings for the management of venous thromboembolism and acute coronary syndrome. Despite LMWH are considered safe and associated with a lower incidence of side effects compared to unfractioned heparin, it is worth considering that the use of LWMH can be associated with complications. Some of these, such as bleeding and thrombocytopenia, are well-known, whereas other ones are often underestimated leading to a diagnostic delay. In this case report, we describe a case of a 73-years-old man who recently started nadroparin for deep vein thrombosis presenting with acute hepatitis. The diagnostic workup of drug-induced liver injury (Dili) requires the exclusion of other causative agents and temporal association between the initiation of the culprit drug and hyper aminotransferasemia. This clinical case analyzes how to deal with a suspicion of Dili and consider LWMH as a potential cause of Dili, which requires a modification of the anticoagulant treatment.
KW - Drug induced liver injury
KW - Liver histopathology
KW - Low molecular weight heparin
KW - Nadroparin
KW - Venous thromboembolism
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U2 - 10.26355/eurrev_201909_18888
DO - 10.26355/eurrev_201909_18888
M3 - Article
C2 - 31539157
AN - SCOPUS:85072208596
VL - 23
SP - 7649
EP - 7654
JO - European Review for Medical and Pharmacological Sciences
JF - European Review for Medical and Pharmacological Sciences
SN - 1128-3602
IS - 17
ER -