Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia

Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia

Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thro...

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Main Authors: Thomas Godet, Sébastien Perbet, Aurélien Lebreton, Guillaume Gayraud, Sophie Cayot, Aymeric Tremblay, Aurélie Ravinet, Sébastien Christophe, Renaud Guérin, Julien Pascal, Matthieu Jabaudon, Amr Hassan, Anne-Françoise Sapin, Jean-Etienne Bazin, Jean-Michel Constantin
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2013/849168
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Summary:Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thrombopenia (HIT) is skin necrosis at injection sites. We report the case of a patient presenting with skin necrosis witnessing an HIT after RRT, without thrombocytopenia. The mechanism remains unclear. Anti-PF4/heparin antibodies, functional tests (HIPA and/or SRA), and skin biopsy are of great help to evaluate differential diagnosis with a low pretest probability 4T’s score.
ISSN:2090-6560
2090-6579

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