Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Apr 30:65:102370.
doi: 10.1016/j.amsu.2021.102370. eCollection 2021 May.

Unfractionated heparin as a safe alternative in a case of low molecular weight heparin-induced thrombocytosis: A case report

Salem Jabira  1 , Hassan Mitwally  2 , Mohamed Saad  2 , Edin Karic  1 , Khaled Gazwi  1 , Hani Elzeer  1 , Moustafa Elshafei  1
Affiliations
Case Reports

Unfractionated heparin as a safe alternative in a case of low molecular weight heparin-induced thrombocytosis: A case report

Salem Jabira et al. Ann Med Surg (Lond). .

Abstract

Introduction and importance: Low molecular weight heparins are rarely associated with thrombocytosis. However, the safety of transitioning to unfractionated heparin is unknown.

Case presentation: We report a case of a 47-year-old South Asian male who presented to the hospital after ingestion of a caustic liquid. He received subcutaneous enoxaparin 40 mg once daily for prophylaxis against venous thromboembolism. His platelet count increased from the baseline of 748 × 109/L to a peak of 1213 × 109/L, after which enoxaparin was changed to unfractionated heparin. His platelet count returned to normal within seven days. The modified Naranjo scale with thrombocytosis-specific criteria was 6, indicating a probable association with enoxaparin.

Clinical discussion: In this case, the patient developed thrombocytosis after initiation of low-molecular weight heparin and platelet count normalized after shifting to unfractionated heparin.

Conclusion: Clinicians should suspect LMWH-induced thrombocytosis when platelet count elevation cannot be explained by other causes. Unfractionated heparin might be a safe alternative in case of low molecular weight heparin-induced thrombocytosis.

Keywords: Adverse reaction; Drug-related side effect; Enoxaparin; Heparin; Low-molecular-weight; Thrombocytosis.

PubMed Disclaimer

Conflict of interest statement

All authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Trend of platelet counts with unfractionated heparin (UFH) and enoxaparin.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Mismetti P., Laporte S., Darmon J.Y., Buchmüller A., Decousus H. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery. Br. J. Surg. 2001;88(7):913–930. doi: 10.1046/j.0007-1323.2001.01800.x. - DOI - PubMed
    1. Wein L., Wein S., Haas S.J., Shaw J., Krum H. Pharmacological venous thromboembolism prophylaxis in hospitalized medical patients: a meta-analysis of randomized controlled trials. Arch. Intern. Med. 2007;167(14):1476–1486. doi: 10.1001/archinte.167.14.1476. - DOI - PubMed
    1. Cestac P., Bagheri H., Lapeyre-Mestre M. Utilisation and safety of low molecular weight heparins: prospective observational study in medical inpatients. Drug Saf. 2003;26(3):197–207. doi: 10.2165/00002018-200326030-00005. - DOI - PubMed
    1. Levesque H., Verdier S., Cailleux N. Low molecular weight heparins and hypoaldosteronism. Br. Med. J. 1990;300(6737):1437–1438. doi: 10.1136/bmj.300.6737.1437. - DOI - PMC - PubMed
    1. Liautard C., Nunes A.-M.C., Vial T. Low-molecular-weight heparins and thrombocytosis. Ann. Pharmacother. 2002;36(9):1351–1354. doi: 10.1345/aph.1A461. - DOI - PubMed

Publication types