Rolle der Vitamin-K-Antagonisten aus Sicht des Hepatologen |
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Authors: | G. Kneiseler A. Canbay Prof. Dr. G. Gerken |
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Affiliation: | Klinik für Gastroenterologie und Hepatologie, Zentrum für Innere Medizin, Universit?tsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland. |
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Abstract: | Vitamin K antagonists are often used as oral anticoagulants for primary and secondary prevention of thromboembolic events. Vitamin K antagonists induce an anticoagulant effect by interfering with the vitamin K metabolism in the liver. Well-known complications are bleeding events and skin necrosis. Recent data indicate increasing numbers of cases with hepatic complications due to vitamin K antagonists ranging from mild hepatopathy to acute liver failure with high mortality. Hepatotoxicity is usually developed after a few months of latency, which is associated with unspecific symptoms, jaundice, elevated transaminase levels as well as cholestatic enzymes. Hepatotoxicity due to vitamin K antagonists is seldom; however, it should be considered in cases of elevated liver enzymes. In this case coumarin therapy should be discontinued. Caution is needed when changing to another coumarin derivative because cross-reactivity has been described. |
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