A caution regarding the use of low-molecular weight heparin in pediatric otogenic lateral sinus thrombosis.
Lateral sinus thrombosis (LST), a rare complication of otitis media, is managed by antibiotics, surgery and anticoagulation. Traditionally, post-operative anticoagulation has been achieved by intravenous unfractionated heparin followed by oral warfarin. Fractionated, or low-molecular weight heparin derivatives (LMWH) have been introduced recently. There has been minimal literature to date regarding their use for the management of LST. We present use of the LMWH enoxaparin (Lovenox) for otogenic LST in two children, both of whom experienced hemorrhagic complications. On this basis and in the context of a literature review, we urge caution when using LMWH for pediatric otogenic LST.
Shah
Udayan K
UK
Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA. shah@email.chop.edu
Jubelirer
Tracey F
TF
Fish
Jonathan D
JD
Elden
Lisa M
LM
D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D010033:Otitis Media / Q000150:complications; D019106:Postoperative Hemorrhage / Q000139:chemically induced*
D000925:Anticoagulants; D017984:Enoxaparin