PMID- 34732938
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221202
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 56
IP  - 6
DP  - 2021 Dec
TI  - A Severe Case of Idiosyncratic Hepatotoxicity with Unfractionated Heparin.
PG  - 777-785
LID - 10.1177/0018578720965435 [doi]
AB  - The authors describe a case of clinically apparent idiosyncratic hepatotoxicity 
      in association with unfractionated heparin (UFH). A 52-year-old woman with 
      increasingly symptomatic rheumatic mitral valvular disease and severe pulmonary 
      hypertension underwent elective minimally-invasive bioprosthetic mitral valve 
      replacement. The patient received 42 000 units of UFH intraoperatively 10 days 
      after receiving 3100 units during a left heart catheterization. Standard 
      prophylactic doses of unfractionated heparin were started on POD 2 for prevention 
      of venous thromboembolism. On the evening of postoperative day (POD) 3, the 
      patient was lethargic, encephalopathic, and hypoglycemic with an acute liver 
      injury and hyperlactatemia. Similar events occurred on POD 7 after clinical 
      improvement from the initial injury and an unintentional rechallenge with UFH. 
      Heparins are usually not suspected of idiosyncratic hepatotoxicity due to their 
      widespread utilization and reports of milder episodes of hepatotoxicity. This 
      case highlights the need to consider UFH in the differential of drug-induced 
      liver injury, including severe cases.
CI  - (c) The Author(s) 2020.
FAU - Haney, Jason Samuel
AU  - Haney JS
AUID- ORCID: 0000-0002-2676-6579
AD  - Medical University of South Carolina College of Pharmacy, Charleston, SC, USA.
FAU - Carter, Cassandra Tatum
AU  - Carter CT
AD  - Medical University of South Carolina College of Pharmacy, Charleston, SC, USA.
FAU - Downey, Jacklyn
AU  - Downey J
AUID- ORCID: 0000-0001-6285-0404
AD  - Prisma Health Greenville Memorial Medical Campus, Greenville, SC, USA.
FAU - Ilic, Romina
AU  - Ilic R
AD  - Roper Hospital, Charleston, SC, USA.
LA  - eng
PT  - Journal Article
DEP - 20201020
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC8559046
OTO - NOTNLM
OT  - adverse drug reactions
OT  - anticoagulants
OT  - cardiovascular
OT  - gastrointestinal disorders
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/11/05 06:00
MHDA- 2021/11/05 06:01
PMCR- 2022/12/01
CRDT- 2021/11/04 06:18
PHST- 2021/11/04 06:18 [entrez]
PHST- 2021/11/05 06:00 [pubmed]
PHST- 2021/11/05 06:01 [medline]
PHST- 2022/12/01 00:00 [pmc-release]
AID - 10.1177_0018578720965435 [pii]
AID - 10.1177/0018578720965435 [doi]
PST - ppublish
SO  - Hosp Pharm. 2021 Dec;56(6):777-785. doi: 10.1177/0018578720965435. Epub 2020 Oct 
      20.