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Related Experiment Videos

Heparin-induced recurrent anaphylaxis.

Y Berkun1, Y S Haviv, L B Schwartz

  • 1Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah University Hospital, Jerusalem, Israel. berkun@md.huji.ac.il

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|January 25, 2005
PubMed
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This study details a rare case of heparin-induced anaphylaxis in a patient undergoing hemodialysis. Diagnosis was confirmed by elevated tryptase levels and positive skin tests, leading to successful treatment with an alternative anticoagulant.

Area of Science:

  • Clinical Immunology
  • Pharmacology
  • Nephrology

Background:

  • Immediate-type hypersensitivity reactions to heparin are rare but can be severe.
  • Mechanisms of heparin hypersensitivity and mast cell involvement are not fully understood.

Observation:

  • A patient with end-stage renal disease experienced recurrent anaphylaxis during heparinized hemodialysis.
  • Clinical presentation was initially obscured by hemodialysis-related side effects.

Findings:

  • Diagnosis of heparin hypersensitivity was confirmed by elevated mature serum tryptase levels and positive intradermal skin tests to heparin and enoxaparin.
  • Skin tests with danaparoid were negative, and it was used successfully as an anticoagulant for 3 years.

Implications:

Related Experiment Videos

  • This is the first reported case of heparin-induced anaphylaxis confirmed by elevated mature tryptase.
  • Physicians must be aware of and prepared to diagnose/manage immediate hypersensitivity reactions to heparin.
  • Alternative anticoagulants like danaparoid can be safely used in hypersensitive patients.