A Review and Assessment of Drug-Induced Thrombocytosis

Vo, Quyen T; Thompson, Dennis F.

doi:10.1177/1060028018819450

Cited by 20 publications

(18 citation statements)

References 81 publications

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“…In addition to the subcutaneous injections of enoxaparin, the patient was given oral medications including amlodipine, telmisartan, aspirin, and atorvastatin. Previous research have revealed that some medications including All-Trans Retinoic Acid (ATRA), Antibiotics, Clozapine, Epinephrine, Gemcitabine, Low-Molecular-Weight Heparins (LMWHs), and Vinca Alkaloids may lead to drug-induced thrombocytosis, and the strongest evidence of causality supports LMWH and neonatal drug withdrawal as the main etiologic factors [6]. Based on this facts, we suspected that the patient's thrombocytosis was induced by enoxaparin, so anticoagulation with rivaroxaban instead was initiated on the 16th day of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Enoxaparin-induced reactive thrombocytosis: a case report

Tao¹,

Cheng²

2021

Thrombosis J

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Background Enoxaparin is an anticoagulant that falls in the class of medications called low molecular weight heparins (LMWHs), and is used to prevent or treat patients with deep vein thrombosis (DVT) and pulmonary embolism. Enoxaparin is the most widely used LMWH for DVT prophylaxis following knee or hip replacement surgery. Common side effects of enoxaparin include bleeding, petechiae at the injection site, and thrombocytopenia. However, reactive thrombocytosis is a rarely reported adverse reaction. We managed a patient who developed enoxaparin-associated thrombocytosis, which was completely resolved after treatment cessation. 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 Enoxaparin-induced reactive thrombocytosis should be suspected in patients with thrombocytosis following enoxaparin administration as an anticoagulant to prevent certain complications.

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Section: Discussionmentioning

confidence: 99%

Enoxaparin-induced reactive thrombocytosis: a case report

Tao¹,

Cheng²

2021

Thrombosis J

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“…Drug-induced thrombocytopenia is considered one of the causes of secondary or reactive thrombocytosis [ 7 ]. Many drugs were reported previously to cause thrombocytosis e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Many drugs were reported previously to cause thrombocytosis e.g. penicillins, cephalosporins, clozapine, and others [ [7] , [8] , [9] , [10] , [11] ].…”

Section: Discussionmentioning

confidence: 99%

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

Jabira

Mitwally

Saad

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction and importance Low molecular weight heparins are rarely associated with thrombocytosis. However, the safety of transitioning to unfractionated heparin is unknown. Case presentation 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 × 10 9 /L to a peak of 1213 × 10 9 /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. Clinical discussion In this case, the patient developed thrombocytosis after initiation of low-molecular weight heparin and platelet count normalized after shifting to unfractionated heparin. Conclusion 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.

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“…Гемостаз являє собою фізіологічний процес своєрідного балансування між процесами підтримки рідкого стану крові та тромбоутворення. Ця система є складною, динамічною компонентою, яка складається з пов'язаних між собою плазмових факторів та клітин -тромбоцитів [14,17].…”

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Assessment of the Effect of Carbon Monoxide Donor (Corm-2) on Blood Clotting Rate Under Conditions of Immune Response

Vysochanska¹,

Beschasnyi²,

Hasiuk³

2021

Prir. alʹm., Ser.: Bìol. nauki

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The balance between the liquid state support of the blood and the thrombus formation process depends on the activity of plasma factors and thrombocytes. In a vascular injury condition, thrombocytes form a thrombocyte plug, vasoconstriction and, further, take part in the restoration of the tissues. Reducing the clotting function of thrombocytes is a current problem. The search for agents - modulators of thrombocyte activity - is a promising area of research. Compounds - gas-transmitters can be used to model the activity of thrombocytes hemostasis. Carbon monoxide (CO) gas belongs to this group as well. CO in very low concentrations affects in a different way the process of apoptosis, stimulates calcium-dependent potassium channels, and changes the activity of mitochondria. To investigate the effect of CO on blood clotting rate, laboratory mice were injected with the compound CO donor (CORM-2). This substance was administered separately during the inductive and productive phases of the immune response. The dynamics of the immune response were measured by IgA, IgM and IgG immunoglobulin levels. It was found that blood clotting was intensified under the influence of CORM-2 (20 mg/kg). Especially, the increase was during the productive phase. At the end of the experiment, the percentage of megakaryoblasts in the total population of thrombocyte precursors decreased in the bone marrow of animals (to which CORM-2 was administered). Against this background, an increased content of megakaryocytes was found in the group that received CORM-2 during the productive phase. In the group that received CORM-2 during the inductive phase, in addition to an increase in megakaryocyte levels, there was an increase in thrombocyte levels. The group that received CORM-2 during the productive phase also had a predominance of metamegakaryocytes and reducing of thrombocyte amount. Key words: thrombocytes, carbon monoxide donor, CORM-2, immune response phases.

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A Review and Assessment of Drug-Induced Thrombocytosis

Cited by 20 publications

References 81 publications

Enoxaparin-induced reactive thrombocytosis: a case report

Enoxaparin-induced reactive thrombocytosis: a case report

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

Assessment of the Effect of Carbon Monoxide Donor (Corm-2) on Blood Clotting Rate Under Conditions of Immune Response

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