Intravenous challenge with heparins in patients with delayed-type skin reactions after subcutaneous administration of the drug.

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摘要：

Delayed-phase reactions after subcutaneous (s.c.) injection of high- or low-molecular-weight heparins are not rare. They present as indurated s.c. swelling with overlying erythema/eczema, causing burning or itching (1). Occasionally, an exanthematous reaction supervenes. If further anticoagulation is necessary, cross-reactivity with other anticoagulants (heparinoids), such as dermatan sulfate (OrgaranTM) or sodium pentosan polysulfate (FibrezymTM), is common (2). Even after the introduction of the new anticoagulant lepirudin (RefludanTM), heparins remain the drugs of choice, particularly for intravenous (i.v.) anticoagulation. The most important differential diagnosis from delayed-type reactions after s.c. heparin is the initial stage of heparin-induced skin necrosis, which may be a sign of heparin-induced thrombocytopenia (HIT). Cutaneous necrosis is characterized by a well-defined eschar surrounded by an inflammatory halo, and can occur either at the injection site or at distant sites.

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关键词：

heparin heparinoid delayed‐type skin reaction medicaments intravenous challenge

DOI：

10.1111/j.1600-0536.1998.tb05823.x

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年份：

2010