Anticoagulants and transaminase elevation.

Case 1: Mr F., a 65-year-old man with hypertension and atrial fibrillation, began longterm anticoagulation with warfarin 1 year ago. He presented with a 1-week history of nausea, anorexia, jaundice, and altered mental status. His laboratory workup showed elevated serum transaminases and direct bilirubin. Could warfarin be potentially responsible? Case 2: Mr S., a 75-year-old man with diabetes and coronary artery disease, presented with an acute anterior myocardial infarction. Echocardiography showed a left ventricular aneurysm with apical akinesis and thrombus. He was started on enoxaparin, and 3 days later, he developed a rise in alanine aminotransferase (ALT) 5 times the upper limit of normal (ULN). Could this laboratory abnormality be related to enoxaparin?