Widespread skin necrosis associated with unfractionated heparin therapy in a patient under chronic coumarin anticoagulation.

Details

Serval ID
serval:BIB_E10FC284C23D
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Widespread skin necrosis associated with unfractionated heparin therapy in a patient under chronic coumarin anticoagulation.
Journal
Journal of the European Academy of Dermatology and Venereology
Author(s)
Sanchez-Politta S., Angelillo-Scherrer A., Masouyé I., Borradori L.
ISSN
0926-9959
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
20
Number
3
Pages
327-30
Language
english
Notes
Case Reports Journal Article --- Old month value: Mar
Abstract
Coumarins and heparins are commonly used for temporary or long-term anticoagulation. These molecules have potentially devastating side-effects, including widespread skin necrosis. We report the case of an elderly patient under oral anticoagulation with coumarins, who developed widespread necrotic cutaneous lesions upon introduction of intravenous and subcutaneous unfractionated heparin administration for a surgical procedure. Laboratory investigations revealed the presence of circulating antibodies directed against heparin-platelet factor 4. The lesions slowly resolved after withdrawal of heparin, whereas oral coumarin was re-introduced without complications. This case illustrates the rare occurrence of skin necrosis as a result of unfractionated heparin in a patient under chronic coumarin medication. Recognition of this rare complication and appropriate laboratory testing is mandatory for prompt institution of alternative anticoagulant therapies.
Keywords
Aged, Anticoagulants, Arm, Cardiomyopathies, Colonic Neoplasms, Coumarins, Diagnosis, Differential, Drug Administration Schedule, Heparin, Humans, Infusions, Intravenous, Injections, Subcutaneous, Male, Necrosis, Postoperative Complications, Skin
Pubmed
Web of science
Create date
25/01/2008 16:22
Last modification date
20/08/2019 17:05
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