Allergic anaphylaxis due to subcutaneously injected heparin
Please always quote using this URN: urn:nbn:de:bvb:20-opus-96214
- 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 toHeparins 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.…
Author: | Diana Anders, Axel Trautmann |
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URN: | urn:nbn:de:bvb:20-opus-96214 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie |
Language: | English |
Parent Title (English): | Allergy, Asthma & Clinical Immunology |
Year of Completion: | 2013 |
Source: | In: Allergy, Asthma & Clinical Immunology (2013) 9: 1, doi:10.1186/1710-1492-9-1 |
URL: | http://www.aacijournal.com/content/9/1/1 |
DOI: | https://doi.org/10.1186/1710-1492-9-1 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | Allergy; Anaphylaxis; Basophil activation test; Enoxaparin; Heparin; Hypersensitivity; Immediate-type; Immunoglobulin E |
Release Date: | 2014/04/23 |
Collections: | Open-Access-Publikationsfonds / Förderzeitraum 2013 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung |