Asian Journal of Case Reports in Medicine and Health

Heparin-induced thrombocytopenia (HIT) is a serious immune-mediated adverse drug reaction that paradoxically increases thrombotic risk despite declining platelet counts. We present a case of a 75-year-old male admitted for bilateral knee osteoarthritis who developed thrombocytopenia following heparin administration. Local examination of both knees revealed mild varus deformity, diffuse tenderness, and palpable bony crepitus, with painful flexion and extension. The patient's platelet count showed a temporal decline from 2.21 to 1.94 lakhs/cumm (221 × 10⁹/L to 194 × 10⁹/L) during heparin therapy, with subsequent recovery to 2.85 lakhs/cumm (285 × 10⁹/L) after discontinuation. This case emphasises the importance of routine platelet monitoring, early recognition of HIT, and prompt intervention to prevent potentially life-threatening thrombotic complications.