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Updated: Jul 19, 2026
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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Reactive thrombocytosis associated with enoxaparin.
Margaret C Hummel1, Bryan C Morse, Lloyd E Hayes
1Department of Pharmacy, Clinical Services, Greenville Hospital System University Medical Center, Greenville, South Carolina 29605, USA.
Pharmacotherapy
|October 27, 2006
Summary
Enoxaparin can cause reactive thrombocytosis, a condition of high platelet count. Switching to unfractionated heparin may resolve this adverse effect, as seen in a patient with a head injury.
Area of Science:
- Pharmacology
- Hematology
Background:
- Thrombocytosis, characterized by elevated platelet counts, can be reactive and drug-induced.
- Enoxaparin, a low-molecular-weight heparin, is commonly used for venous thromboembolism prophylaxis.
Observation:
- A patient with a closed head injury developed significant thrombocytosis (platelet count up to 1005 x 10(3)/mm(3)) during enoxaparin therapy.
- Discontinuation of enoxaparin led to normalization of platelet count, while re-initiation caused a recurrence of thrombocytosis.
Findings:
- Enoxaparin was identified as a likely reversible cause of drug-induced reactive thrombocytosis in this patient.
- Switching from enoxaparin to unfractionated heparin, along with mechanical prophylaxis, successfully managed the thrombocytosis without complications.
Implications:
- This case suggests unfractionated heparin as a potential alternative for patients experiencing enoxaparin-induced thrombocytosis.
- Clinicians should consider drug-induced thrombocytosis in patients on enoxaparin presenting with elevated platelet counts.
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