Subcutaneous heparin-induced thrombocytopenia

Two patients developed severe and symptomatic thrombocytopenia which was clearly related to the every-12-hour subcutaneous administration of heparin sodium. One patient died of hemorrhage while the other patient's platelet count normalized after withdrawal of the therapy. The literature reveals 27 cases of significant thrombocytopenia associated with intravenous heparin administration. In light of the increasing use of low-dose subcutaneous heparin therapy it is important to recognize that this side effect may occur. Periodic platelet counts are recommended for these patients.