Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management

Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and sp...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Trautmann, Axel [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Allergy testing Drug allergy Drug hypersensitivity Local reaction Provocation test Skin test

Anmerkung:	© Springer Medizin Verlag GmbH, a part of Springer Nature 2018

Übergeordnetes Werk:	Enthalten in: Allergo journal international - München : Urban & Vogel, 2014, 27(2018), 4 vom: 25. Mai, Seite 122-125
Übergeordnetes Werk:	volume:27 ; year:2018 ; number:4 ; day:25 ; month:05 ; pages:122-125

Links:	Volltext

DOI / URN:	10.1007/s40629-018-0063-1

Katalog-ID:	SPR037002465

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allfields	10.1007/s40629-018-0063-1 doi (DE-627)SPR037002465 (SPR)s40629-018-0063-1-e DE-627 ger DE-627 rakwb eng Trautmann, Axel verfasserin aut Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Medizin Verlag GmbH, a part of Springer Nature 2018 Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213 Enthalten in Allergo journal international München : Urban & Vogel, 2014 27(2018), 4 vom: 25. Mai, Seite 122-125 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:27 year:2018 number:4 day:25 month:05 pages:122-125 https://dx.doi.org/10.1007/s40629-018-0063-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 27 2018 4 25 05 122-125
spelling	10.1007/s40629-018-0063-1 doi (DE-627)SPR037002465 (SPR)s40629-018-0063-1-e DE-627 ger DE-627 rakwb eng Trautmann, Axel verfasserin aut Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Medizin Verlag GmbH, a part of Springer Nature 2018 Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213 Enthalten in Allergo journal international München : Urban & Vogel, 2014 27(2018), 4 vom: 25. Mai, Seite 122-125 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:27 year:2018 number:4 day:25 month:05 pages:122-125 https://dx.doi.org/10.1007/s40629-018-0063-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 27 2018 4 25 05 122-125
allfields_unstemmed	10.1007/s40629-018-0063-1 doi (DE-627)SPR037002465 (SPR)s40629-018-0063-1-e DE-627 ger DE-627 rakwb eng Trautmann, Axel verfasserin aut Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Medizin Verlag GmbH, a part of Springer Nature 2018 Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213 Enthalten in Allergo journal international München : Urban & Vogel, 2014 27(2018), 4 vom: 25. Mai, Seite 122-125 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:27 year:2018 number:4 day:25 month:05 pages:122-125 https://dx.doi.org/10.1007/s40629-018-0063-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 27 2018 4 25 05 122-125
allfieldsGer	10.1007/s40629-018-0063-1 doi (DE-627)SPR037002465 (SPR)s40629-018-0063-1-e DE-627 ger DE-627 rakwb eng Trautmann, Axel verfasserin aut Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Medizin Verlag GmbH, a part of Springer Nature 2018 Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213 Enthalten in Allergo journal international München : Urban & Vogel, 2014 27(2018), 4 vom: 25. Mai, Seite 122-125 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:27 year:2018 number:4 day:25 month:05 pages:122-125 https://dx.doi.org/10.1007/s40629-018-0063-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 27 2018 4 25 05 122-125
allfieldsSound	10.1007/s40629-018-0063-1 doi (DE-627)SPR037002465 (SPR)s40629-018-0063-1-e DE-627 ger DE-627 rakwb eng Trautmann, Axel verfasserin aut Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Medizin Verlag GmbH, a part of Springer Nature 2018 Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213 Enthalten in Allergo journal international München : Urban & Vogel, 2014 27(2018), 4 vom: 25. Mai, Seite 122-125 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:27 year:2018 number:4 day:25 month:05 pages:122-125 https://dx.doi.org/10.1007/s40629-018-0063-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 27 2018 4 25 05 122-125
language	English
source	Enthalten in Allergo journal international 27(2018), 4 vom: 25. Mai, Seite 122-125 volume:27 year:2018 number:4 day:25 month:05 pages:122-125
sourceStr	Enthalten in Allergo journal international 27(2018), 4 vom: 25. Mai, Seite 122-125 volume:27 year:2018 number:4 day:25 month:05 pages:122-125
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Allergy testing Drug allergy Drug hypersensitivity Local reaction Provocation test Skin test
isfreeaccess_bool	false
container_title	Allergo journal international
authorswithroles_txt_mv	Trautmann, Axel @@aut@@
publishDateDaySort_date	2018-05-25T00:00:00Z
hierarchy_top_id	779923413
id	SPR037002465
language_de	englisch
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author	Trautmann, Axel
spellingShingle	Trautmann, Axel misc Allergy testing misc Drug allergy misc Drug hypersensitivity misc Local reaction misc Provocation test misc Skin test Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
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topic_title	Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management Allergy testing (dpeaa)DE-He213 Drug allergy (dpeaa)DE-He213 Drug hypersensitivity (dpeaa)DE-He213 Local reaction (dpeaa)DE-He213 Provocation test (dpeaa)DE-He213 Skin test (dpeaa)DE-He213
topic	misc Allergy testing misc Drug allergy misc Drug hypersensitivity misc Local reaction misc Provocation test misc Skin test
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title	Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
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title_full	Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
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title_sort	allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
title_auth	Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
abstract	Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. © Springer Medizin Verlag GmbH, a part of Springer Nature 2018
abstractGer	Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. © Springer Medizin Verlag GmbH, a part of Springer Nature 2018
abstract_unstemmed	Background Heparins are unproblematic drugs from an allergist’s perspective, since despite frequent application heparin hypersensitivity is quite rarely in clinical routine. Methods This article provides an overview of selected scientific articles and is based on a literature search in PubMed and specialist databases. Results Most commonly, heparin allergic patients develop lymphocyte-mediated, eczematous local reactions directly at the injection sites (usually on the lower abdomen) hours to days after initiating regular subcutaneous heparin injections. The high sensitivity of skin-prick and intradermal testing procedures means that subcutaneous provocation tests are seldom necessary for diagnosis. The “compartment allergy” phenomenon is a particular feature of heparin-induced local allergic reactions. Here, the route of application determines whether an allergic inflammatory reaction develops. In case of heparin-allergic individuals, injections into the subcutaneous tissue cause eczematous plaques, whereas intravenous injections or infusions are well tolerated. Since the introduction of low molecular weight heparin preparations, the incidence of potentially life-threatening heparin-induced thrombocytopenia caused by activating IgG (Ig: immunoglobulin) antibodies against heparin-platelet factor 4 (PF4) complexes on platelet membranes has declined. IgE-mediated heparin allergy with immediate-type anaphylactic reactions seems to be extremely rare. © Springer Medizin Verlag GmbH, a part of Springer Nature 2018
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title_short	Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management
url	https://dx.doi.org/10.1007/s40629-018-0063-1
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doi_str	10.1007/s40629-018-0063-1
up_date	2024-07-03T20:43:17.550Z
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Allergic heparin hypersensitivity – recommendations for diagnostic work up and patient management

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