Association of heparin-induced skin lesions, intracutaneous tests, and heparin-induced IgG
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 thromboemboli...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1999
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| In: |
Allergy
Year: 1999, Volume: 54, Issue: 5, Pages: 473-477 |
| ISSN: | 1398-9995 |
| DOI: | 10.1034/j.1398-9995.1999.00048.x |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1034/j.1398-9995.1999.00048.x Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1398-9995.1999.00048.x 
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| Author Notes: | J Harenberg, G Huhle, L Wang, U Hoffmann, Ch Bayerl, M Kerowgan |
| Summary: | 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. |
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| Item Description: | Elektronische Reproduktion der Druck-Ausgabe 24 Dezember 2001 Gesehen am 11.05.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1398-9995 |
| DOI: | 10.1034/j.1398-9995.1999.00048.x |