Severe Skin Necrosis Associated with Heparin in Hemodialysis
作者:
Martine Leblanc,
Louise F. Roy,
Louis Legault,
Louis R. Dufresne,
Claude Morin,
Claude Thuot,
期刊:
Nephron
(Karger Available online 1994)
卷期:
Volume 68,
issue 1
页码: 133-137
ISSN:1660-8151
年代: 1994
DOI:10.1159/000188232
出版商: S. Karger AG
关键词: Heparin;Skin necrosis;Platelet aggregation;Hemodialysis
数据来源: Karger
摘要:
Skin necrosis is a well-recognized although rare complication of continuous heparin therapy. We report the case of a 66-year-old diabetic woman with end-stage renal failure who received intermittent intravenous heparin during hemodialysis. She developed severe necrotic cutaneous ulcers over both legs, with typical histological findings. Thrombocytopenia never occurred but platelet studies demonstrated enhanced aggregation when heparin was added in vitro. Platelet-aggregating immunoglobulins produced in response to heparin can lead to thrombotic events. Thrombocytopenia usually develops prior to the onset of cutaneous lesions, but as in this case, may be absent. Heparin should be discontinued when the condition is recognized. Unfortunately, a poor outcome is frequently observed.
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