Use of weight-based dosing of enoxaparin for venous thromboembolism prophylaxis in an extremely underweight elderly patient

A review of the literature revealed little evidence for optimal anticoagulation dosing for VTE prophylaxis in adult patients weighing under 40 kg. Various adjustment strategies have been utilized; however, there is no available evidence pertaining to patients at the extreme of low weight represented by the reported case or to attainment of an anti-factor Xa level within the therapeutic range in such patients. This case represents the use of a weight-based enoxaparin strategy for an extremely underweight elderly patient and the attainment of a therapeutic prophylactic anti-factor Xa level.