Association of heparin-induced skin lesions, intracutaneous tests, and heparin-induced IgG

• Verfasst von: Harenberg, Job [VerfasserIn]
• Verfasst von: Huhle, Günter [VerfasserIn]
• Verfasst von: Wang, Lianchun [VerfasserIn]
• Verfasst von: Hoffmann, Ursula [VerfasserIn]
• Verfasst von: Bayerl, Christiane [VerfasserIn]
• Verfasst von: Kerowgan, Mohammed [VerfasserIn]
• Titel: Association of heparin-induced skin lesions, intracutaneous tests, and heparin-induced IgG
• Verf.angabe: J Harenberg, G Huhle, L Wang, U Hoffmann, Ch Bayerl, M Kerowgan
• Jahr: 1999
• Umfang: 5 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 24 Dezember 2001 ; Gesehen am 11.05.2022
• Titel Quelle: Enthalten in: Allergy
• Ort Quelle: Oxford : Wiley, 1978
• Jahr Quelle: 1999
• Band/Heft Quelle: 54(1999), 5, Seite 473-477
• ISSN Quelle: 1398-9995
• DOI: doi:10.1034/j.1398-9995.1999.00048.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: danaparoid
• Sach-SW: heparin allergy
• Sach-SW: intracutaneous test
• Sach-SW: low-molecular-weight heparin
• Sach-SW: r-hirudin
• K10plus-PPN: 1801383685

Abstract

Background: Cutaneous heparin-induced allergic reactions to subcutaneous heparin may begin 2-5 days after administration. The relation of the delayed-type hypersensitivity and a systemic immunologic response is controversial. The present investigation aimed to analyze the occurrence of thromboembolic complication, pathologic heparin-induced platelet activation (HIPA), and the presence of circulating heparin-induced IgG in patients with heparin-induced skin reactions. Methods: Intracutaneous tests, HIPA assay, and heparin-heparin IgG antibodies were performed in nine patients with heparin-induced skin lesions. Results: Six of eight patients showed positive intracutaneous tests to heparin and to four low-molecular-weight heparins. Three of six heparin-positive patients presented hypersensitivity to a heparinoid, too. Two of three patients had a positive HIPA test and elevated heparin-induced IgG antibodies. Both patients developed complications presenting as heparin-induced skin necrosis or arterial thrombosis. Two of nine patients were treated with danaparoid, 4/9 patients received r-hirudin, and 1/9 received oral coumarin. In 2/9 patients, anticoagulant therapy was stopped, but these patients will receive r-hirudin if indicated. Conclusions: On the basis of the coincidence of local and systemic hyperreactivity to heparin and danaparoid, patients with heparin-induced skin lesions should receive r-hirudin, a nonheparin compound, for anticoagulant treatment.