1. age \< 18 years 2. on-going treatment with anticoagulant drugs 3. platelet count \<100.000/mmc 4. history of heparin-induced thrombocytopenia 5. allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; 6. active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment 7. recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery 8. chronic assumption or oral corticosteroids 9. pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; 10. clinical decision to withhold life-sustaining treatment or "too sick to benefit"; 11. presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); 12. lack or withdrawal of informed consent.

1. age \< 18 years 2. on-going treatment with anticoagulant drugs 3. platelet count \<100.000/mmc 4. history of heparin-induced thrombocytopenia 5. allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; 6. active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment 7. recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery 8. chronic assumption or oral corticosteroids 9. pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; 10. clinical decision to withhold life-sustaining treatment or "too sick to benefit"; 11. presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); 12. lack or withdrawal of informed consent.

age < 18 years on-going treatment with anticoagulant drugs platelet count <100.000/mmc history of heparin-induced thrombocytopenia allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery chronic assumption or oral corticosteroids pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; clinical decision to withhold life-sustaining treatment or "too sick to benefit"; presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); lack or withdrawal of informed consent.

age < 18 years on-going treatment with anticoagulant drugs platelet count <100.000/mmc history of heparin-induced thrombocytopenia allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery chronic assumption or oral corticosteroids pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; clinical decision to withhold life-sustaining treatment or "too sick to benefit"; presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); lack or withdrawal of informed consent.

1. age < 18 years 2. on-going treatment with anticoagulant drugs 3. platelet count <100.000/mmc 4. history of heparin-induced thrombocytopenia 5. allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; 6. active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment 7. recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery 8. chronic assumption or oral corticosteroids 9. pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; 10. clinical decision to withhold life-sustaining treatment or "too sick to benefit"; 11. presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); 12. lack or withdrawal of informed consent.

1. age < 18 years 2. on-going treatment with anticoagulant drugs 3. platelet count <100.000/mmc 4. history of heparin-induced thrombocytopenia 5. allergy to sodium enoxaparine or other lmwh, unfractionated heparin or metylprednisolone; 6. active bleeding or on-going clinical condition deemed at high risk of bleeding contraindicating anticoagulant treatment 7. recent (in the last 1 month prior to randomization) brain, spinal or ophthalmic surgery 8. chronic assumption or oral corticosteroids 9. pregnancy or breastfeeding or positive pregnancy test. in childbearing age women, before inclusion, a pregnancy test will be performed if not available; 10. clinical decision to withhold life-sustaining treatment or "too sick to benefit"; 11. presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition); 12. lack or withdrawal of informed consent.