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: