scholarly journals Extensive skin necrosis after periprosthetic knee infection: a case that highlights the possibility of complications induced by low-molecular-weight heparin

2021 ◽  
Vol 6 (6) ◽  
pp. 235-240
Author(s):  
Hélder Fonte ◽  
André Carvalho ◽  
João Rosa ◽  
Cláudia Pereira ◽  
Alexandre Pereira ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Molecular Weight ◽  
Skin Necrosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Soft Tissue Management ◽  
Knee Infection ◽  
Complex Approach ◽  
Wide Range ◽  
Periprosthetic Knee Infection

Abstract. We describe a case of a patient with atrial fibrillation, anticoagulated with dabigatran, that developed severe knee skin necrosis in the setting of an acute periprosthetic knee infection, after initiating low-molecular-weight heparin. A wide range of etiology hypotheses was discussed within a multidisciplinary team. The complex approach consisted of treating the underlying infection, multiple types of soft-tissue management, and stopping enoxaparin.

Homozygous Protein C Deficiency: Description of a New Mutation and Successful Treatment with Low Molecular Weight Heparin

1998 ◽  
Vol 79 (04) ◽  
pp. 756-761 ◽  
Author(s):  
Paul Monagle ◽  
Maureen Andrew ◽  
Jacqueline Halton ◽  
Richard Marlar ◽  
Lawrence Jardine ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Bone Density ◽  
Skin Necrosis ◽  
Protein C ◽  
Low Molecular Weight Heparin ◽  
Whole Body ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
New Mutation

SummaryWe present a kindred with a new mutation of the protein C gene, in which the proband had an unusual clinical presentation. The relationship between warfarin induced skin necrosis and level of anticoagulation was investigated. The pharmacokinetics of protein C concentrate was assessed to determine frequency of replacement therapy. The clinical and biochemical efficacy of therapy with low molecular weight heparin (LMWH) was assessed. The effect of long-term LMWH on bone density in the growing child was monitored using whole body densitometry.Warfarin therapy required an INR of greater than 3.5 to avoid skin necrosis. If protein C replacement was to be used, doses of 100 U/kg/day would have been required to maintain protein C levels consistently at or above 0.20 U/ml. While receiving prophylactic therapy with LMWH for almost 3 years, there were no episodes of recurrent thrombosis, no skin necrosis and no bleeding. Biochemical markers of in vivo thrombin generation were suppressed and within the normal range. Bone density continued to increase at the normal rate throughout the treatment period.LMWH is an effective form of long-term therapy for homozygous protein C deficient patients with measurable protein C levels.

scholarly journals Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Thomas Godet ◽  
Sébastien Perbet ◽  
Aurélien Lebreton ◽  
Guillaume Gayraud ◽  
Sophie Cayot ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Adverse Event ◽  
Differential Diagnosis ◽  
Renal Replacement Therapy ◽  
Skin Necrosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Functional Tests ◽  
Low Molecular Weight Heparins ◽  
Heparin Induced Thrombocytopenia

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.

scholarly journals Skin necrosis after subcutaneous low molecular weight heparin injection

1995 ◽  
Vol 49 (3) ◽  
pp. 253-254 ◽  
Author(s):  
Esperanza Real ◽  
Enric Grau ◽  
Miguel Rubio ◽  
Teresa Torrecilla
Keyword(s):  
Molecular Weight ◽  
Skin Necrosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight
Sign in / Sign up

Export Citation Format

Share Document