Enoxaparin-induced hepatotoxicity: clinical cases and literature review

• Main Authors: Yu. N. Krovko, A. V. Shmigelskiy, A. D. Аkhmedov, A. A. Shulgina, V. A. Lukshin, D. Yu. Usachev
• Format: Article
• Language: Russian
• Published: NEW TERRA Publishing House 2021-03-01
• Series: Вестник анестезиологии и реаниматологии
• Subjects: drug-induced liver injury; enoxaparin; low molecular weight heparins; hepatotoxicity; deep vein thrombosis
• Online Access: https://www.vair-journal.com/jour/article/view/501

Low molecular weight heparins, in particular enoxaparin, have a wide range of applications, including prevention and treatment of deep vein thrombosis.  The most common adverse effects of these drugs are bleeding and thrombocytopenia, but a clinician should be aware of another less common but not less important adverse effect such as an elevated transaminase level. In 2019, we observed two cases of enoxaparin-induced hepatotoxicity. In the first one, enoxaparin 0.4 ml subcutaneously twice a day was prescribed to a 40-year-old woman as a bridge therapy to discontinue warfarin before elective surgery. In the second case, a 27-year-old man received enoxaparin 0.4 ml subcutaneously twice a day for the prevention of deep vein thrombosis. The elevation of transaminase level for more than 3 times above the norm was noted in both patients which required discontinuation of the drug.