Phenprocoumon-induced hepatitis mimicking non-A, non-B hepatitis.
A 58-year-old man presented with jaundice 6 months after aortic valve replacement. Although non-A, non-B hepatitis was initially suspected, the final diagnosis of phenprocoumon (Marcoumar)-induced hepatitis progressing to cirrhosis was based on recurrence of jaundice after re-exposure to the drug, improvement after withdrawal and centrilobular necrosis with eosinophilic infiltration in the liver biopsy. Antibodies to hepatitis C virus were absent. The aortic valve was replaced by a bioprosthesis to eliminate the need for life-long anticoagulation.
de Man
R A
RA
Department of Internal Medicine, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Wilson
J H
JH
Schalm
S W
SW
ten Kate
F J
FJ
van Leer
E
E
D000914:Antibodies, Viral / Q000032:analysis / Q000276:immunology; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000009:adverse effects* / Q000627:therapeutic use; D013923:Thromboembolism / Q000188:drug therapy
D000914:Antibodies, Viral; D010644:Phenprocoumon