Unfractionated heparin as a safe alternative in a case of low molecular weight heparin-induced thrombocytosis: A case report

Low molecular weight heparins are rarely associated with thrombocytosis. However, the safety of transitioning to unfractionated heparin is unknown. 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. In this case, the patient developed thrombocytosis after initiation of low-molecular weight heparin and platelet count normalized after shifting to unfractionated heparin. 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. •Low molecular weight heparin-induced thrombocytosis is a rare adverse drug reaction.•Clinicians should anticipate low molecular weight induced thrombocytosis when other causes of thrombocytosis are excluded.•Unfractionated heparin may be a safe therapeutic alternative in case of low molecular weight induced thrombocytosis.