Zusammenfassung
Heparininduzierte Hautnekrosen sind selten und können als Komplikation der immunologisch vermittelten heparininduzierten Thrombozytopenie Typ II (HIT II) beobachtet werden. Wir berichten über eine 62-jährige Patientin, bei der sich 7 Tage nach Beginn der subkutanen Applikation des niedermolekularen Heparins Enoxaparin abdominal eine Nekrose entwickelte. Es ließen sich Antikörper gegen den Platelet-factor-4-Komplex nachweisen, nicht jedoch eine Thrombozytopenie. Es kann spekuliert werden, dass es sich bei der Hautnekrose um die Folge einer isolierten, antikörperbedingten Thrombosierung dermaler Hautgefäße im Rahmen einer HIT II handelte.
Abstract
Most of the rare cases of skin necrosis following heparin injections are associated with the immunologically mediated form of heparin-induced thrombocytopenia II (HIT II). We present a 62-year- old woman who developed a necrotic abdominal lesion seven days after starting daily subcutaneous injections of the low molecular heparin enoxaparin. We detected circulating antibodies against the platelet factor 4-complex but no concomitant thrombocytopenia. An isolated, antibody-mediated thrombosis of dermal vessels is the likely underlying cause of the skin necrosis in HIT II.
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Illes, M., Klaus, S., Simon, J. et al. Hautnekrose als kutane Manifestation einer heparininduzierten Thrombopenie Typ II?. Hautarzt 62, 290–292 (2011). https://doi.org/10.1007/s00105-010-1999-3
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DOI: https://doi.org/10.1007/s00105-010-1999-3
Schlüsselwörter
- Heparininduzierte Thrombozytopenie II
- Enoxaparin
- Platelet-factor-4-Komplex (PF4-Komplex)
- Heparininduzierte Plättchenaggregation (HIPA)
- Review