PHENPROCOUMON - ASSOCIATED HEPATITIS - A RARE COMPLICATION OF ORAL ANTICOAGULATION

Phenprocoumon is a widely used coumarin-anticoagulant and is noted for its bleeding complications. A phenprocoumon-induced hepatitis has onl y been described in very rare cases. We report the case of a 58-year o ld woman in whom jaundice developed after 6 months of therapy with phe nprocoumon given for deep venous thrombosis. Liver biopsy revealed a c hronic-active hepatitis with bridging necrosis and inflammatory septa. After withdrawal of phenprocoumon and prednisolon-therapy the elevate d liver enzymes returned to normal and a control biopsy showed regress ion of the inflammatory changes. Being very rare the diagnosis of phen procoumon-induced hepatitis is primarily one of exclusion. Typically t here is a latency period of 3 to 9 months, which usually shortens on r eexposure to a few weeks. Patients with vital indication for anticoagu lation pose a serious therapeutic problem.