Skin necrosis at the injection site induced by low-molecular-weight heparin: case report and review.
Heparin-induced skin necrosis at the injection site is a rare adverse effect, more commonly associated with standard heparins than with low-molecular-weight heparins (LMWH) and its mechanism remains unclear. We report a case of LMWH-induced skin necrosis in a female during prophylactic treatment with LMWH after a surgical procedure. Determination of heparin-platelet-factor-4(PF4)-induced antibodies was positive. This case describes the occurrence of LMWH-induced skin necrosis and antibodies to heparin-PF4 complex, suggesting that this effect is more frequent than previously suspected.
Santamaría
A
A
Departamento de Hemostasia y Trombosis, Hospital de Sant Pau, Barcelona, España.
Romaní
J
J
Souto
J C
JC
López
A
A
Mateo
J
J
Fontcuberta
J
J
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007279:Injections, Subcutaneous; D009336:Necrosis; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000139:chemically induced*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight