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Related Experiment Videos

Delayed-type hypersensitivity to subcutaneous enoxaparin

J Méndez1, M E Sanchís, R de la Fuente

  • 1Sección de Alergia, Hospital del Rio Hortega, Valladolid, Spain.

Allergy
|November 20, 1998
PubMed
Summary
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Delayed hypersensitivity reactions to enoxaparin injections can occur. Subcutaneous challenge tests are most reliable for diagnosing cross-allergenicity between heparins.

Area of Science:

  • Immunology
  • Dermatology
  • Pharmacology

Background:

  • Low-molecular-weight heparins like enoxaparin are crucial for managing thromboembolic disorders.
  • Cutaneous reactions, specifically delayed hypersensitivity, can manifest as erythematous plaques at injection sites.
  • Investigating the allergenic potential of enoxaparin is essential due to its widespread use.

Observation:

  • Three patients presented with erythematous, infiltrated plaques following enoxaparin injections.
  • Diagnostic procedures included patch tests with various heparins, subcutaneous, and intravenous challenge tests.
  • Histopathological examination of a skin biopsy revealed features consistent with delayed-type hypersensitivity.

Findings:

  • Patch tests showed varied reactivity to enoxaparin, nadroparin, and sodium heparin.

Related Experiment Videos

  • Subcutaneous challenge tests were positive in two patients, while intravenous tests were negative.
  • Evidence suggests a type IV hypersensitivity reaction to enoxaparin.

    • Implications:

    • These findings highlight the potential for cross-allergenicity between unfractionated heparin and low-molecular-weight heparins.
    • The subcutaneous challenge test emerges as a superior diagnostic method for heparin-induced hypersensitivity.
    • Understanding these reactions is vital for safe and effective anticoagulant therapy.