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

نویسندگان

  • 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
چکیده

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.

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عنوان ژورنال:

دوره 2013  شماره 

صفحات  -

تاریخ انتشار 2013