Abstract
Abstract
Background
Enoxaparin is an anticoagulant that falls in the class of medications called low molecular weight heparins (LMWHs), and is used to prevent or treat patients with deep vein thrombosis (DVT) and pulmonary embolism. Enoxaparin is the most widely used LMWH for DVT prophylaxis following knee or hip replacement surgery. Common side effects of enoxaparin include bleeding, petechiae at the injection site, and thrombocytopenia. However, reactive thrombocytosis is a rarely reported adverse reaction. We managed a patient who developed enoxaparin-associated thrombocytosis, which was completely resolved after treatment cessation.
Case presentation
A 78-year-old female was hospitalized for post-hip replacement rehabilitation. Low molecular weight heparin 40 mg/day was administered subcutaneously to prevent deep venous thrombosis (DVT). At admission, her platelet count was normal (228 × 109/L) and her white blood cell count was slightly elevated (12.91 × 109/L). Seven days after admission, the patient developed thrombocytosis, which peaked on the 14th day (836 × 109/L), while her white blood cell count had returned to normal (8.86 × 109/L). Her therapeutic regimen was reviewed, and enoxaparin was identified as a potentially reversible cause of reactive thrombocytosis. Switching from enoxaparin to rivaroxaban lead to a gradual decrease in the patient’s platelet count, which eventually returned to normal levels 16 days after enoxaparin was discontinued. No complications secondary to thrombocytosis was observed, and no conclusion was reached on the use of small doses of aspirin for antithrombotic therapy under these circumstances.
Conclusion
Enoxaparin-induced reactive thrombocytosis should be suspected in patients with thrombocytosis following enoxaparin administration as an anticoagulant to prevent certain complications.
Publisher
Springer Science and Business Media LLC
Reference12 articles.
1. Noble S, Peters DH, Goa KL. Enoxaparin: A reappraisal of its pharmacology and clinical applications in the prevention and treatment of thromboembolic disease [J]. Drugs. 1995;49(3):388–410.
2. Mousa SA. The Low Molecular Weight Heparin, Tinzaparin, in Thrombosis and Beyond [J]. Cardiovasc Drug Rev. 2006;20(3):199–216.
3. Caprini JA, Arcelus J, Sehgal LR, Cohen EB, Reyna JJ. The use of low molecular weight heparins for the prevention of postoperative venous thromboembolism in general surgery [J]. Int Angiol. 2002;21(1):78–85.
4. Spivak JL, Silver RT. The revised World Health Organization diagnostic criteria for polycythemia vera, essential thrombocytosis, and primary myelofibrosis: an alternative proposal [J]. Blood. 2008;112(2):231–9.
5. Harrison CN, Bareford D, Butt N, Campbell P, Conneally E, Drummond M, et al. Guideline for investigation and management of adults and children presenting with a thrombocytosis [J]. Br J Haematol. 2010;149(3):352–75. https://doi.org/10.1111/j.1365-2141.2010.08122.x.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献