Enoxaparin-induced reactive thrombocytosis: a case report

Area of Science:

• Pharmacology
• Hematology
• Clinical Medicine

Background:

• Enoxaparin is a widely used low molecular weight heparin (LMWH) for preventing deep vein thrombosis (DVT) post-surgery.
• Common side effects include bleeding and thrombocytopenia, but reactive thrombocytosis is a rare adverse reaction.
• This case highlights a rare adverse effect of enoxaparin therapy.

Purpose of the Study:

• To report a case of enoxaparin-associated reactive thrombocytosis.
• To emphasize the importance of considering this rare side effect in patients on enoxaparin.
• To demonstrate the reversibility of enoxaparin-induced thrombocytosis upon drug cessation.

Main Methods:

• A case presentation of a 78-year-old female patient post-hip replacement.
• Monitoring of platelet and white blood cell counts during enoxaparin administration for DVT prophylaxis.
• Discontinuation of enoxaparin and switch to rivaroxaban upon development of thrombocytosis.

Main Results:

• The patient developed significant thrombocytosis (platelet count peaked at 836 × 10^9/L) during enoxaparin therapy.
• Platelet counts normalized 16 days after discontinuing enoxaparin and switching to rivaroxaban.
• No complications related to thrombocytosis were observed.

Conclusions:

• Enoxaparin-induced reactive thrombocytosis is a rare but possible adverse reaction.
• Clinicians should suspect this condition in patients presenting with thrombocytosis while on enoxaparin.
• Discontinuation of enoxaparin is an effective treatment for this condition.