Hypersensitivity reactions to heparins

González-Delgado, Purificación; Fernández, J.

doi:10.1097/aci.0000000000000281

Cited by 15 publications

(14 citation statements)

References 59 publications

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“…These data suggest that hormonal and metabolic features are predisposing factors for heparin hypersensitivity. 5 Confirming literature data, LMWHs were the culprit heparins in the majority of our cases, probably because of their widespread use, regardless of their molecular weight. 7 Affected patients usually develop localized reactions at the heparin injection sites that may become generalized if treatment is not discontinued.…”

Section: Discussionsupporting

confidence: 90%

“…4 All patients underwent subcutaneous provocation tests with fondaparinux, with the prophylactic unit dose (0.5 mL) being administered in three fractions (0.05, 0.15 and 0.3 mL, every 30 minutes) and with a 7-day follow-up. 5…”

Section: Methodsmentioning

confidence: 99%

“…In patients with negative patch test results, prick tests and intradermal tests were carried out with immediate and delayed readings . All patients underwent subcutaneous provocation tests with fondaparinux, with the prophylactic unit dose (0.5 mL) being administered in three fractions (0.05, 0.15 and 0.3 mL, every 30 minutes) and with a 7‐day follow‐up …”

Section: Methodsmentioning

confidence: 99%

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Skin tests in patients with delayed and immediate hypersensitivity to heparins: A case series

et al. 2018

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K E Y W O R D S : alternative, cross-reactions, cutaneous adverse drug reactions, delayed-type hypersensitivity, heparins, immediate-type hypersensitivity, intradermal test, patch test, prick test, skin tests Heparins constitute a group of anticoagulants that are widely used in clinical practice for the prophylaxis and treatment of thromboembolic events. Among the adverse events induced by heparins, delayed-type hypersensitivity (DTH) reactions are commonly reported, mostly as eczematous patches localized on the injection sites. 1 Only a few cases of immediate-type hypersensitivity (ITH) reactions have been described, manifesting as urticaria, angioedema, palmoplantar itch, dyspnoea, and anaphylaxis. 2,3

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Skin tests in patients with delayed and immediate hypersensitivity to heparins: A case series

et al. 2018

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“…Heparins [34], mainly low molecular weight heparins, have been widely prescribed as an anticoagulant drug to treat complications of COVID-19 infection. The most common type of hypersensitivity reactions to low molecular weight heparins consists of the local delayed-type ones that may become widespread and occur in 7.5% of patients.…”

Section: Drug and Latex Allergymentioning

confidence: 99%

Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

Cardinale

Ciprandi

Barberi³

et al. 2020

Ital J Pediatr

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The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic. Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.

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“…Clinical manifestations of DHR include erythematous plaques and maculopapular exanthemas at the injection site. Immediate-type hypersensitivity reactions (IHR) to LMWHs are extremely rare and are limited to case reports (Gonzalez-Delgado and Fernandez 2016;MacLaughlin et al 2002;Anders and Trautmann 2013;Leguísamo et al 2015). Clinical manifestations of IHR include urticaria, hypotension, angioedema, pruritus and anaphylaxis.…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity reactions to low molecular weight heparins: different patterns of cross-reactivity in 3 patients

Nahal

Cegec

Turk

et al. 2018

Can. J. Physiol. Pharmacol.

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Low molecular weight heparins (LMWHs) are used for a variety of indications. The most common type of hypersensitivity reactions to LMWHs are delayed-type hypersensitivity reactions (DHR). Immediate-type hypersensitivity reactions (IHR) occur only sporadically. Cross-reactivity of different LMWHs is a common and unpredictable problem. We present 2 cases of patients who developed DHR to nadroparin and enoxaparin, respectively. The third case presents a patient who developed IHR to nadroparin. Skin tests confirmed the hypersensitivity in all cases. In the cases of DHR, a skin test negative LMWH was identified and was tolerated in a challenge test. In the IHR case, cross-reactivity to all tested LMWHs was established. We hypothesize that the degree of cross-reactivity might depend on the type of hypersensitivity reaction with immediate reactions linked to more extensive cross-reactivity than delayed reactions. This is important to consider because, at least in some cases, a safe alternative LMWH can be identified.

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Hypersensitivity reactions to heparins

Cited by 15 publications

References 59 publications

Skin tests in patients with delayed and immediate hypersensitivity to heparins: A case series

Skin tests in patients with delayed and immediate hypersensitivity to heparins: A case series

Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

Hypersensitivity reactions to low molecular weight heparins: different patterns of cross-reactivity in 3 patients

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