AI Article Synopsis

  • Low molecular weight heparins (LMWH) are often used in ICU for preventing blood clots and treating blood clot disorders during renal replacement therapy (RRT).
  • A rare side effect of LMWH can be skin necrosis at injection sites, which may indicate an immunoallergic reaction known as heparin-induced thrombocytopenia (HIT).
  • In a reported case, a patient developed skin necrosis after RRT without showing low platelet counts, and various tests were suggested to help diagnose the condition, given the low likelihood indicated by the 4T's scoring system.

Article Abstract

Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thrombopenia (HIT) is skin necrosis at injection sites. We report the case of a patient presenting with skin necrosis witnessing an HIT after RRT, without thrombocytopenia. The mechanism remains unclear. Anti-PF4/heparin antibodies, functional tests (HIPA and/or SRA), and skin biopsy are of great help to evaluate differential diagnosis with a low pretest probability 4T's score.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835902PMC
http://dx.doi.org/10.1155/2013/849168DOI Listing

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