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      About Digestion: 3.2 Impact Factor I 6.4 CiteScore I 0.914 Scimago Journal & Country Rank (SJR)

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      Enoxaparin-Induced Liver Injury

      case-report

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          Abstract

          Enoxaparin, a form of low-molecular-weight heparin, can cause a rare, underreported, and often reversible form of hepatocellular injury. This report describes a case of enoxaparin-induced hepatotoxicity in a 61-year-old male diagnosed with pulmonary embolism. Elevations of liver enzymes were noted within 1 week of starting the drug, followed by a dramatic improvement upon its discontinuation, with subsequent normalization in the following days.

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          Low molecular weight heparin.

          Steven LeVine, J Hirsh (1992)
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            Drug-Induced Liver Injury: Why is the Roussel Uclaf Causality Assessment Method (RUCAM) Still Used 25 Years After Its Launch?

            Gaby Danan, Rolf Teschke (2018)
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              Elevation of hepatic transaminases after enoxaparin use: case report and review of unfractionated and low-molecular-weight heparin-induced hepatotoxicity.

              R Carlson, P Gleason, S. Sen (2001)
              Enoxaparin, a low-molecular-weight heparin (LMWH), is widely used for the treatment and prophylaxis of thromboembolic disorders, such as deep vein thrombosis. Low-molecular-weight heparin products have smaller and more uniform molecular weights than unfractionated heparin, allowing them to exhibit a much greater affinity for factor Xa than factor IIa. Compared with traditional unfractionated heparin, LMWHs have proved to be equally efficacious and may be safer. The distinctive characteristics of LMWHs have resulted in decreased rates of bleeding and equivalent rates of thrombocytopenia compared with unfractionated heparin. This favorable safety profile has been identified in several studies and may have led clinicians to believe that LMWHs have lower frequencies of all common side effects. A 66-year-old woman developed increased hepatic transaminases during treatment with enoxaparin for a deep vein thrombosis; they returned to normal after enoxaparin discontinuation. A causal relationship between unfractionated heparin and asymptomatic, transient increases in hepatic transaminase levels has been documented; these increased levels also appear to be an underrecognized, adverse effect of LMWH therapy.
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                Author and article information

                Journal
                Journal ID (publisher-id): CRG
                Journal ID (pmc): CRG
                Journal ID (doi): 10.1159/issn.1662-0631
                Title: Case Reports in Gastroenterology
                Publisher: S. Karger AG
                ISSN (Electronic): 1662-0631
                Publication date Subscription-year: 2020
                Publication date Collection: May – August 2020
                Publication date (Electronic): 10 June 2020
                Volume: 14
                Issue: 2
                Pages: 315-319
                Affiliations
                [_a] aDepartment of Gastroenterology, Bronx Care Health System, Bronx, New York, USA
                [_b] bDepartment of Internal Medicine, Bronx Care Health System, Bronx, New York, USA
                Author notes
                *Shehriyar Mehershahi, Department of Gastroenterology, Bronx Care Health System, 1650 Grand Concourse, Bronx, NY 10457 (USA), smehersh@bronxcare.org
                Article
                Publisher ID: 508471 Pmcid ID: PMC7315174 Other ID: Case Rep Gastroenterol 2020;14:315–319
                DOI: 10.1159/000508471
                PMC ID: PMC7315174
                PubMed ID: 32595436
                SO-VID: 257dc03b-f8c4-4eef-8455-335ca0806342
                Copyright © © 2020 The Author(s). Published by S. Karger AG, Basel
                License:

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 08 April 2020
                Date accepted : 01 May 2020
                Page count
                Tables: 1, Pages: 5
                Categories
                Subject: Single Case

                ScienceOpen disciplines: Oncology & Radiotherapy,Gastroenterology & Hepatology,Surgery,Nutrition & Dietetics,Internal medicine
                Keywords: Drug-induced liver injury,Viral hepatitis,Enoxaparin,Non-alcoholic fatty liver disease
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Gastroenterology & Hepatology, Surgery, Nutrition & Dietetics, Internal medicine
                Keywords: Drug-induced liver injury, Viral hepatitis, Enoxaparin, Non-alcoholic fatty liver disease

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