North American Journal of Medical Sciences

CASE REPORT
Year
: 2015  |  Volume : 7  |  Issue : 9  |  Page : 407--410

Acute liver failure after initiation of rivaroxaban: A case report and review of the literature


Muhammad Baig, Kenneth J Wool, Jewell H Halanych, Rehan A Sarmad 
 Department of Internal Medicine, UAB Health Center Montgomery, Montgomery, Alabama, USA

Correspondence Address:
Muhammad Baig
1304 Seaton Circle, Montgomery, Alabama - 36116
USA

Context: Rivaroxaban is a direct factor Xa inhibitor approved for the prevention of thromboembolism. Drug induced liver injury has been increasingly reported with rivaroxaban recently, but actual liver failure has not been reported. Case Report: We present a case report on the probable occurrence of acute liver failure with rivaroxaban therapy. An 89 year old woman with history of atrial fibrillation was hospitalized for biventricular congestive heart failure with passive congestion of liver, which responded to furosemide. She was discharged home on rivaroxaban for prevention of thrombo-embolism. Liver function tests upon discharge returned to almost normal range. One week later, she presented with abdominal pain and was found to have highly elevated liver enzymes, elevated bilirubin, and an abnormal coagulation profile. A day later, she developed hepatic encephalopathy, suggesting liver failure. Conclusion: Liver enzymes declined rapidly with the discontinuation of all of her medications, however patient died because of multi-organ failure. The causality assessment in this patient was źDQ╗probableźDQ╗ with rivaroxaban.


How to cite this article:
Baig M, Wool KJ, Halanych JH, Sarmad RA. Acute liver failure after initiation of rivaroxaban: A case report and review of the literature.North Am J Med Sci 2015;7:407-410


How to cite this URL:
Baig M, Wool KJ, Halanych JH, Sarmad RA. Acute liver failure after initiation of rivaroxaban: A case report and review of the literature. North Am J Med Sci [serial online] 2015 [cited 2020 Oct 31 ];7:407-410
Available from: https://www.najms.org/article.asp?issn=1947-2714;year=2015;volume=7;issue=9;spage=407;epage=410;aulast=Baig;type=0