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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.

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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

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