Eczematous plaques related to unfractionated and low-molecular-weight heparin in pregnancy: cross-reaction with danaparoid sodium.
The use of low-molecular-weight heparin has been expanded to prevent pregnancy complications such as pregnancy loss, intra-uterine growth restriction and severe early-onset pre-eclampsia in high-risk patients with evidence of acquired or congenital thrombophilia. Therefore, the number of patients with side effects from low-molecular-weight heparin is expected to increase. We describe two women with infiltrating patchy plaques that developed in reaction to low-molecular-weight heparin during pregnancy. In the first patient, a switch to other formulations of heparin and heparinoid failed; the second patient, however, did well when enoxaparin was replaced with dalteparin. This report confirms the risk of skin reactions to enoxaparin and dalteparin, and reports on a skin reaction associated with danaparoid sodium in a pregnant woman.
Blickstein
Dorith
D
Institute of Hematology Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Hod
Moshe
M
Bar
Jacob
J
D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D002809:Chondroitin Sulfates / Q000009:adverse effects*; D017985:Dalteparin / Q000009:adverse effects; D003871:Dermatan Sulfate / Q000009:adverse effects*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D004485:Eczema / Q000139:chemically induced*; D017984:Enoxaparin / Q000009:adverse effects; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006497:Heparan Sulfate / Q000009:adverse effects*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*
D001241:Aspirin; D002809:Chondroitin Sulfates; D017985:Dalteparin; D003871:Dermatan Sulfate; D004338:Drug Combinations; D017984:Enoxaparin; D006495:Heparin, Low-Molecular-Weight; D006497:Heparan Sulfate; C035838:danaparoid