Enoxaparin: A cause of postoperative fever?

Enoxaparin (clexane) is a low-molecular-weight heparin commonly prescribed for the chemoprophylaxis of venous thromboembolism in postoperative hip or knee replacement or abdominal surgery patients. We herein report a case of persistent postoperative fever in a patient, likely due to enoxaparin use....

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Bibliographic Details
Published in:Medical hypotheses 2018-12, Vol.121, p.47-48
Main Authors: Ng, Qin Xiang, Seng, Chusheng, Ho, Collin Yih Xian, Yeo, Wee-Song
Format: Article
Language:English
Subjects:
Aged
Animals
Anticoagulants
Arthroplasty, Replacement, Knee - adverse effects
Cattle
Clexane
Diabetes Complications
Drug fever
Enoxaparin
Enoxaparin - adverse effects
Female
Fever
Fever - etiology
Humans
Hypersensitivity
Obesity - complications
Osteoarthritis, Knee - complications
Osteoarthritis, Knee - surgery
Postoperative
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Swine
Treatment Outcome
Venous Thromboembolism
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Summary:Enoxaparin (clexane) is a low-molecular-weight heparin commonly prescribed for the chemoprophylaxis of venous thromboembolism in postoperative hip or knee replacement or abdominal surgery patients. We herein report a case of persistent postoperative fever in a patient, likely due to enoxaparin use. Prompt resolution of the patient’s fever was observed after discontinuation of subcutaneous enoxaparin for chemical thromboprophylaxis. Reliable incidence data are lacking. A comprehensive search of PubMed, MEDLINE and EMBASE databases, as well as grey literature, found only two prior single case reports on enoxaparin-related fever. The mechanism responsible for the febrile reaction is likely an idiosyncratic response. Enoxaparin is typically derived from bovine or porcine intestines and lungs, hence its potential to cause hypersensitivity reactions is perhaps unsurprising. Clinicians should be alert to this possibility.
ISSN:0306-9877
1532-2777
DOI:10.1016/j.mehy.2018.09.027