Drug-induced liver injury associated with acenocumarol exposure

Abstract

Oral anticoagulants are widely used for several medical conditions. The coumarins (phenprocoumon, warfarin, and acenocumarol) have been the mainstay for anticoagulant therapy for many decades. Considering the widespread use of these drugs, reports of liver damage due to their prescription are infrequent. Hepatic injury due to warfarin and phenprocoumon is well recognized, whereas liver toxicity related to acenocumarol has been reported less frequently. Here, we present the case of a young man who developed acute hepatitis after receiving acenocumarol for the treatment of Paget-Schroetter syndrome. Once we ruled out the most common causes of liver diseases, the drug was withdrawn and liver function tests returned to normal values. This case suggests a potential relationship between acenocumarol and liver toxicity. In conclusion, we recommend that in patients who present a sudden rise in liver function test values after acenocumarol exposure, drug-induced liver injury should be suspected.