Probable Enoxaparin-Induced Liver Injury in a Young Patient: A Case Report of a Diagnostic Challenge.

Low molecular weight heparin (LMWH) is associated with elevated liver enzyme levels in a small percentage of patients. Elevations more than five times the upper limit of normal are uncommon and have been noted to primarily occur in patients receiving higher doses. The literature reports mild, primarily asymptomatic cases, with adverse effects at higher therapeutic doses. We report the case of a 27-year-old woman who developed drug-induced liver injury (DILI) while receiving enoxaparin during admission for a loculated pleural effusion secondary to pulmonary tuberculosis. The Roussel Uclaf Causality Assessment Method (RUCAM) score delineated enoxaparin as the likely cause.