JAUNDICE ASSOCIATED WITH ACENOCOUMAROL EXPOSURE

A 69-year-old man developed cholestatic liver enzyme disturbances thre e and a half weeks after starting treatment with acenocoumarol because of a deep venous thrombosis in his leg. Serological testing showed no signs of recent viral infections. A presumptive diagnosis of hepatoto xicity caused by the use of acenocoumarol was made and the anticoagula nt was replaced by low molecular weight heparin. Three weeks after wit hdrawal of the acenocoumarol, the enzymes had improved. The patient ma de a full recovery within two months. This case suggests a causal rela tionship between acenocoumarol exposure and liver damage. (C) 1998 Pub lished by Elsevier Science B.V.