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Kamat A, McGrath M, Weyand A. Enoxaparin-induced DRESS syndrome in a pediatric patient. Pediatr Blood Cancer 2023; 70:e30622. [PMID: 37580897 DOI: 10.1002/pbc.30622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Aarti Kamat
- Department of Pediatrics, University of Michigan Medicine Medical School, Ann Arbor, Michigan, USA
- Division of Pediatric Hematology/Oncology, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA
| | - Mary McGrath
- Department of Pediatrics, University of Michigan Medicine Medical School, Ann Arbor, Michigan, USA
- Division of Pediatric Hematology/Oncology, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA
| | - Angela Weyand
- Department of Pediatrics, University of Michigan Medicine Medical School, Ann Arbor, Michigan, USA
- Division of Pediatric Hematology/Oncology, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA
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Saraiva S, Martins M, Sereno S, Ferreira P, Pinto A, Rasteiro C. Cutaneous hypersensitivity reaction to low molecular weight heparins in pregnancy, cross reactivity and prednisolone treatment: A case report. Obstet Med 2022. [DOI: 10.1177/1753495x221102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In pregnant women, low molecular weight heparin is recommended as the preferred agent for venous thromboembolism prophylaxis and treatment. Despite their widespread application, heparin-induced skin lesions are probably under-reported and under-estimated. We present a case report of a primigravida treated with low molecular weight heparin for deep vein thrombosis, who developed a delayed-type hypersensitivity reaction to enoxaparin, tinzaparin and dalteparin. As the patient was pregnant, treatment options were restricted. Tolerance was achieved with dalteparin with adjuvant administration of prednisolone. An attempt to decrease prednisolone dose triggered delayed-type hypersensitivity reaction recurrence that was solved by keeping the initial prednisolone prescription. To the best of our knowledge, there are no described cases using this approach. In cases of delayed-type hypersensitivity reaction to low molecular weight heparin during pregnancy our case suggests that switching low molecular weight heparin and adjuvant administration of prednisolone can be an option.
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Affiliation(s)
- Susana Saraiva
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Matilde Martins
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Sara Sereno
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Patrícia Ferreira
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Augusta Pinto
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Cátia Rasteiro
- Serviço de Obstetrícia do Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal
- Faculdade de Ciências Médicas, Universidade da Beira Interior, Covilhã, Portugal
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