Tolerance of Fondaparinux in Immediate-type Hypersensitivity to Heparins

Trog, Luisa M.; Kahle, Birgit; Schindewolf, Marc; Jappe, Uta; Ludwig, Ralf J.

doi:10.1016/j.amjmed.2015.06.024

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…LMWH and UFH are the safest option anticoagulants during pregnancy, however their use associated with increased immunological adverse reactions especially in obese pregnant women. Therefore, based on the present case report and its efficacy and tolerability, fondaparinux was the only non-heparin alternative anticoagulant option during pregnancy [9,10]. Safety of the foetus is always an issue when drug is prescribed for pregnant women.…”

Section: Discussionmentioning

confidence: 79%

“…Fondaparinux is a synthetic pentasaccharide specifically bind to antithrombin in reversible manner and reinforces its inhibitory properties mainly towards factor Xa which is inhibited 300 times faster in the presence of fondaparinux. Despite the limited experience during pregnancy to a small cohort of patients, fondaparinux is actually considered to nonheparin alternative of choice in cases of hypersensitivity to UFH and LMWHs [9,10]. We Hematol Med Oncol, 2016 doi: 10.15761/HMO.1000112 retrospectively describe an apparent relationship between enoxaparin and unfractionated heparin (UFH) in a woman with gestational thrombocytopenia developing a hypersensitivity reactions.…”

Section: Introductionmentioning

confidence: 99%

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Hypersensitivity reactions to enoxaparin and unfractionated heparin in a pregnant woman with gestational thrombocytopenia: A case report

Al-Eidan¹,

Al-Qhtani²,

Alsubaie³

et al. 2016

Hematol Med Oncol

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Background: The risk of venous thromboembolism (VTE) and arterial thrombosis (stroke and heart attack) increases in women during pregnancy. Enoxaparin (a low molecular weight heparin) and unfractionated heparin are extensively used in the VTE prophylaxis and therapeutic doses.Aims: We retrospectively describe an apparent relationship between enoxaparin and unfractionated heparin (UFH) in a woman with gestational thrombocytopenia developing a hypersensitivity reactions.Case presentation: we report a clinical scenario of a 43 years old pregnant women (gravida 18, para 12 and living 6) with co-morbid obesity (BMI 47.9) and well known to have a gestational thrombocytopenia during the last two pregnancies. She was administered enoxaparin 0.4ml (40 IU) daily for VTE prophylaxis. After three days, the patient came with hypersensitivity reactions like erythema, pain, swelling, irritation at the site of injection and rash all over the body (lower limbs, abdomen and neck) appeared after the first dose of enoxaparin. Hypersensitivity skin reaction to enoxaparin was suspected and immediately drug was withdrawn. The performed UFH skin test was negative, and then she was prescribed UFH 5000 units subcutaneous every 12 hours. The patient had similar reaction but a severe form and UFH was discontinued. Fondaparinux was the only nonheparin anticoagulant available and was prescribed for this patient.Conclusions: The patient had an allergic drug reaction and provides an evidence of cross-allergenicity between enoxaparin and UFH. Nonheparin anticoagulant improves both rashes and gestational thrombocytopenia.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Hypersensitivity reactions to enoxaparin and unfractionated heparin in a pregnant woman with gestational thrombocytopenia: A case report

Al-Eidan¹,

Al-Qhtani²,

Alsubaie³

et al. 2016

Hematol Med Oncol

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“…Poprzez inhibicję czynnika Xa może on stabilizować blaszki miażdżycowe, prawdopodobnie poprzez hamowanie ekspresji metaloproteinazy-9 i metaloproteinazy-13 [1]. Jest lekiem z wyboru u osób nietolerujących heparyn [2].…”

Section: Fondaprinux -Istotny Postęp W Zakresie Leczenia Przeciwkrzep...unclassified

Fondaparinux in the treatment of acute coronary syndromes in Poland — from theory to the practice. Experts’ group position paper endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy

Filipiak‬¹,

Wożakowska−Kapłon²,

Witkowski³

et al. 2015

Kardiol Pol

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Tinzaparin sodium

2015

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Tolerance of Fondaparinux in Immediate-type Hypersensitivity to Heparins

Cited by 5 publications

References 6 publications

Hypersensitivity reactions to enoxaparin and unfractionated heparin in a pregnant woman with gestational thrombocytopenia: A case report

Hypersensitivity reactions to enoxaparin and unfractionated heparin in a pregnant woman with gestational thrombocytopenia: A case report

Fondaparinux in the treatment of acute coronary syndromes in Poland — from theory to the practice. Experts’ group position paper endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy

Tinzaparin sodium

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