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

Thomas Godet; Sebastien Perbet; Aurelien Lebreton; Guillaume Gayraud; Sophie Cayot; Aymeric Tremblay; Aurelie Ravinet; Sebastien Christophe; Renaud Guerin; Julien Pascal; Matthieu Jabaudon; Amr Hassan; Anne-Francoise Sapin; Jean-Etienne Bazin; Jean-Michel Constantin

doi:10.1155/2013/849168

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

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

Thomas Godet, Sebastien Perbet, Aurelien Lebreton, Guillaume Gayraud, Sophie Cayot, Aymeric Tremblay, Aurelie Ravinet, Sebastien Christophe, Renaud Guerin, Julien Pascal, …

Case reports in hematology, Vol.2013, pp.849168-3

01/01/2013

DOI: https://doi.org/10.1155/2013/849168

PMCID: PMC3835902

PMID: 24307958

Abstract

Hematology

Life Sciences & Biomedicine

Science & Technology

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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Title: Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia
Creators - without role: Thomas Godet - CHU Clermont-Ferrand, CHU Estaing, Réanimation Adultes & Unité de Soins Continus, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand Cedex 1, France.
Sebastien Perbet - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Aurelien Lebreton - CHU Estaing, CHU Clermont Ferrand, Hematol, F-63003 Clermont Ferrand 1, France
Guillaume Gayraud - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Sophie Cayot - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Aymeric Tremblay - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Aurelie Ravinet - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Sebastien Christophe - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Renaud Guerin - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Julien Pascal - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Matthieu Jabaudon - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Amr Hassan - CHU Estaing, CHU Clermont Ferrand, Anatomopathol, F-63003 Clermont Ferrand 1, France
Anne-Francoise Sapin - CHU Estaing, CHU Clermont Ferrand, Hematol, F-63003 Clermont Ferrand 1, France
Jean-Etienne Bazin - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Jean-Michel Constantin - CHU Estaing, CHU Clermont Ferrand, Reanimat Adultes, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand 1, France
Publication Details: Case reports in hematology, Vol.2013, pp.849168-3
Publisher: Hindawi Publishing Group
Number of pages: 3
Identifiers: 9910797508331
Academic Unit: Taif University
Language: English
Resource Type: Journal article