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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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2013/849168 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Thomas Godet |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9459f16a39ad425fb4d239f721e11404 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-9459f16a39ad425fb4d239f721e114042025-02-03T05:47:51ZengWileyCase Reports in Hematology2090-65602090-65792013-01-01201310.1155/2013/849168849168Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced ThrombocytopeniaThomas Godet0Sébastien Perbet1Aurélien Lebreton2Guillaume Gayraud3Sophie Cayot4Aymeric Tremblay5Aurélie Ravinet6Sébastien Christophe7Renaud Guérin8Julien Pascal9Matthieu Jabaudon10Amr Hassan11Anne-Françoise Sapin12Jean-Etienne Bazin13Jean-Michel Constantin14CHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Hematology, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Anatomopathology, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Hematology, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceCHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, FranceLow 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.http://dx.doi.org/10.1155/2013/849168 |
| spellingShingle | 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 Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia Case Reports in Hematology |
| title | Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia |
| title_full | Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia |
| title_fullStr | Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia |
| title_full_unstemmed | Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia |
| title_short | Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia |
| title_sort | low molecular weight heparin induced skin necrosis without platelet fall revealing immunoallergic heparin induced thrombocytopenia |
| url | http://dx.doi.org/10.1155/2013/849168 |
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