Document Detail

Type IV hypersensitivity to subcutaneous heparin: a new case.
MedLine Citation:
PMID:  9015784     Owner:  NLM     Status:  MEDLINE    
A 71-year-old woman was seen for cutaneous lesions that appeared on her abdomen 15 days after the beginning of subcutaneous injection of nadroparin calcium (Fraxiparina), a low molecular-weight heparin (LMWH). The lesions were very pruriginous, measured 0.5-3 cm, and appeared at and around the point of Fraxiparina injection. Fraxiparina treatment was stopped and the lesions subsided spontaneously in one week. The patient had been treated with intravenous heparin (H) one year before. A 6 mm punch biopsy showed spongiosis and a mild dermal superficial perivascular infiltrate composed of lymphocytes and eosinophils. A challenge test with a therapeutic dose of Fraxiparina produced a lesion similar to those described above. Epicutaneous, prick and intradermal tests with undiluted samples of different H (both preservative-containing and preservative-free) were performed. Patch tests produced a mild erythematous reaction to all H at 48 hours and a (++) reaction at 96 hours. These reactions persisted for one week. Prick tests showed neither an immediate nor a delayed reaction. Intradermal tests with H did not produce an immediate reaction, but induced an infiltrated erythematous reaction at 48 hours that enlarged during the next 2 days and was transformed into pruritic plaques with vesicles. The lesions cleared in two weeks. Our findings confirm a delayed-type hypersensitivity to H and cross-reactivity between unfractioned and LMWH.
M A Gonzalo Garijo; F Revenga Arranz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of investigational allergology & clinical immunology     Volume:  6     ISSN:  1018-9068     ISO Abbreviation:  J Investig Allergol Clin Immunol     Publication Date:    1996 Nov-Dec
Date Detail:
Created Date:  1997-04-09     Completed Date:  1997-04-09     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  9107858     Medline TA:  J Investig Allergol Clin Immunol     Country:  SPAIN    
Other Details:
Languages:  eng     Pagination:  388-91     Citation Subset:  IM    
Allergology Department, Infanta Cristina University Hospital, Badajoz, Spain.
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MeSH Terms
Heparin / adverse effects*,  immunology*
Heparin, Low-Molecular-Weight / adverse effects,  immunology
Hypersensitivity, Delayed / immunology*
Injections, Subcutaneous
Intradermal Tests
Reg. No./Substance:
0/Heparin, Low-Molecular-Weight; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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