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Various toxicities: 3 case reports In a case series, three patients (two women and one man), aged 29-76 years, were described who developed acute on chronic subdural haematoma (one patient), acute rectus sheath haematoma (one patient) and cerebellar haematoma (one patient) following administration of heparin [unfractionated heparin] for venous thromboembolism (VTE) prophylaxis. Additionally, a 29-year-old-man exhibited a lack of efficacy during treatment with protamine-sulfate. Case 1: A 76-year-old underweight woman (weight: 44kg and body mass index (BMI):15.8 kg/m2) with a history of hypertension, peptic ulcer disease, and chronic kidney disease presented to the intensive care unit (ICU) with altered mental status and worsening aphasia. She was receiving continued care for an intracranial haemorrhage suffered 2 weeks previously. Her computed tomography (CT) of the head revealed an acute on subacute subdural haematoma and left cerebral intraparenchymal haemorrhage. On admission, lab tests revealed haemoglobin 9.9 g/dL, haematocrit 31.5% and platelet count 285x103/µL. Her baseline activated partial thromboplastin time (aPTT) was 24 seconds and aPTT measured 6.5 hours after the last dose of heparin was 101.7 seconds. Her vital signs were normal. She had been receiving SC heparin 5000 units every 8 hours, blood samples were drawn for heparin assays, which revealed an anti-Xa concentration of 0.86 unit/mL and a thrombin time of 57.2 seconds. After discontinuation of heparin, serial aPTT levels declined and normalised within 24 hours. Other aetiology of haemorrhage, including autoimmune and hepatic dysfunction were ruled out. Repeat CT of her head indicated reduction in the haematoma and a stable parenchymal haemorrhage. After 7 days, she was discharged for rehabilitation in stable condition. Case 2: A 56-year-old underweight woman (weight: 33kg; BMI: 15.7 kg/m2) with a history of hyperlipidaemia and recent subarachnoid haemorrhage with external ventricular drain (EVD) placement and aneurysm coiling was transferred to the ICU following cardiac arrest. Following the return of spontaneous circulation, she was intubated and started on unspecified broadspectrum antibiotics for treatment of aspiration pneumonia. On admission, lab tests revealed haemoglobin level of 5.6 g/dL which was 9.5 g/dL before 4 hours and platelet count was 227x103/µL. aPTT measured 6 hours after last dose of heparin was 98.8 seconds. No overt signs of bleeding were noted on physical examination. Before her admission, she was receiving SC heparin 5000 units every 8 hours for VTE prophylaxis, which was considered as the likely cause of her haemoglobin drop and was discontinued on admission. Her abdominal CT revealed a ischaemic colitis and a large rectus sheath haematoma. She was considered too high risk for surgery or drainage. Throughout her hospitalisation, she received numerous blood transfusions to maintain a haemoglobin concentration of greater than 7 g/dL, continuous renal replacement therapy for acute renal failure, total parenteral nutrit