Necrotizing skin lesions induced by low-molecular-weight heparin after total knee arthroplasty.
We report the unusual complication of focal necrotizing skin lesions accompanied by moderate thrombocytopenia in a female patient undergoing thromboprophylaxis with low-molecular-weight heparin after total knee arthroplasty. Heparin-induced thrombocytopenia was suspected and confirmed using the heparin-induced platelet activation assay. The skin lesions improved gradually after the discontinuation of heparin application. In addition to the description of this exceptionally rare adverse effect of low-molecular-weight heparin, a brief discussion of previously reported cases is provided.
Plath
J
J
Department of Orthopedics, Faculty of Medicine, University of Rostock, Germany.
Schulze
R
R
Barz
D
D
Krammer
B
B
Steiner
M
M
Anders
O
O
Mach
J
J
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis; D009336:Necrosis; D011183:Postoperative Complications / Q000517:prevention & control; D012867:Skin / Q000473:pathology; D013921:Thrombocytopenia / Q000139:chemically induced; D013923:Thromboembolism / Q000517:prevention & control
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight