Cargando…
Allergic anaphylaxis due to subcutaneously injected heparin
Heparins are one of the most used class of anticoagulants in daily clinical practice. Despite their widespread application immune-mediated hypersensitivity reactions to heparins are rare. Among these, the delayed-type reactions to s.c. injected heparins are well-known usually presenting as circumscr...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565926/ https://www.ncbi.nlm.nih.gov/pubmed/23305328 http://dx.doi.org/10.1186/1710-1492-9-1 |
_version_ | 1782258492663398400 |
---|---|
author | Anders, Diana Trautmann, Axel |
author_facet | Anders, Diana Trautmann, Axel |
author_sort | Anders, Diana |
collection | PubMed |
description | Heparins are one of the most used class of anticoagulants in daily clinical practice. Despite their widespread application immune-mediated hypersensitivity reactions to heparins are rare. Among these, the delayed-type reactions to s.c. injected heparins are well-known usually presenting as circumscribed eczematous plaques at the injection sites. In contrast, potentially life-threatening systemic immediate-type anaphylactic reactions to heparins are extremely rare. Recently, some cases of non-allergic anaphylaxis could be attributed to undesirable heparin contaminants. A 43-year-old patient developed severe anaphylaxis symptoms within 5–10 minutes after s.c. injection of enoxaparin. Titrated skin prick testing with wheal and flare responses up to an enoxaparin dilution of 1:10.000 indicated a probable allergic mechanism of the enoxaparin-induced anaphylaxis. The basophil activation test as an additional in-vitro test method was negative. Furthermore, skin prick testing showed rather broad cross-reactivity among different heparin preparations tested. In the presented case, history, symptoms, and results of skin testing strongly suggested an IgE-mediated allergic hypersensitivity against different heparins. Therefore, as safe alternative anticoagulants the patient could receive beneath coumarins the hirudins or direct thrombin inhibitors. Because these compounds have a completely different molecular structure compared with the heparin-polysaccharides. |
format | Online Article Text |
id | pubmed-3565926 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35659262013-02-11 Allergic anaphylaxis due to subcutaneously injected heparin Anders, Diana Trautmann, Axel Allergy Asthma Clin Immunol Case Report Heparins are one of the most used class of anticoagulants in daily clinical practice. Despite their widespread application immune-mediated hypersensitivity reactions to heparins are rare. Among these, the delayed-type reactions to s.c. injected heparins are well-known usually presenting as circumscribed eczematous plaques at the injection sites. In contrast, potentially life-threatening systemic immediate-type anaphylactic reactions to heparins are extremely rare. Recently, some cases of non-allergic anaphylaxis could be attributed to undesirable heparin contaminants. A 43-year-old patient developed severe anaphylaxis symptoms within 5–10 minutes after s.c. injection of enoxaparin. Titrated skin prick testing with wheal and flare responses up to an enoxaparin dilution of 1:10.000 indicated a probable allergic mechanism of the enoxaparin-induced anaphylaxis. The basophil activation test as an additional in-vitro test method was negative. Furthermore, skin prick testing showed rather broad cross-reactivity among different heparin preparations tested. In the presented case, history, symptoms, and results of skin testing strongly suggested an IgE-mediated allergic hypersensitivity against different heparins. Therefore, as safe alternative anticoagulants the patient could receive beneath coumarins the hirudins or direct thrombin inhibitors. Because these compounds have a completely different molecular structure compared with the heparin-polysaccharides. BioMed Central 2013-01-10 /pmc/articles/PMC3565926/ /pubmed/23305328 http://dx.doi.org/10.1186/1710-1492-9-1 Text en Copyright ©2013 Anders and Trautmann; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Anders, Diana Trautmann, Axel Allergic anaphylaxis due to subcutaneously injected heparin |
title | Allergic anaphylaxis due to subcutaneously injected heparin |
title_full | Allergic anaphylaxis due to subcutaneously injected heparin |
title_fullStr | Allergic anaphylaxis due to subcutaneously injected heparin |
title_full_unstemmed | Allergic anaphylaxis due to subcutaneously injected heparin |
title_short | Allergic anaphylaxis due to subcutaneously injected heparin |
title_sort | allergic anaphylaxis due to subcutaneously injected heparin |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565926/ https://www.ncbi.nlm.nih.gov/pubmed/23305328 http://dx.doi.org/10.1186/1710-1492-9-1 |
work_keys_str_mv | AT andersdiana allergicanaphylaxisduetosubcutaneouslyinjectedheparin AT trautmannaxel allergicanaphylaxisduetosubcutaneouslyinjectedheparin |