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Immediate-type hypersensitivity reactions: 2 case reports In a case series, a 66-year-old man developed immediate-type hypersensitivity reaction presenting as urticaria, dyspnoea and angioedema of neck while a 32-year-old woman developed immediate-type hypersensitivity reaction presenting as severe lifethreatening anaphylactic shock during treatment with nadroparin calcium [nadroparin; routes, dosages and outcomes not stated]. The 66-year-old man was scheduled to undergo a surgery due to the obliteration of arteria femoralis profunda. Prior to the surgery, he was pre-medicated with nadroparin calcium. However, following five minutes of the nadroparin calcium administration, he developed urticaria, dyspnoea and angioedema of neck. After four weeks, he underwent a skin prick test with nadroparin calcium, bemiparin-sodium and synthetic pentasaccharide fondaparinux-sodium. A positive immediate-type reaction was seen nadroparin calcium, bemiparin-sodium [bemiparine] and enoxaparin-sodium [enoxaparin]. However, no reaction was developed to synthetic pentasaccharide fondaparinux-sodium [fondaparinux] upon skin prick test, intradermal test and a challenge test. Therefore, fondaparinux-sodium was used as an alternative anticoagulant. The 32-year-old woman received topical nadroparin calcium for left calf deep vein thrombosis. However, within five minutes of the application, she developed severe life-threatening anaphylactic shock with skin, respiratory, cardiovascular and gastrointestinal symptoms. After four weeks, she underwent skin prick test with nadroparin calcium, bemiparin-sodium [bemiparine] and enoxaparin-sodium [enoxaparin] and fondaparinux-sodium[fondaparinux]; however, the test was positive to nadroparin calcium, bemiparin-sodium and enoxaparin-sodium while negative to fondaparinux-sodium. An intradermal test with fondaparinux-sodium was positive. Hence, no low molecular weight heparin was recommended. Racansky M, et al. Rare hypersensitivity reactions to low molecular weight heparins: two case reports. World Allergy Organization Journal 13: 100247 abstr. P136, No. 8, 803515272 Aug 2020. Available from: URL: http://doi.org/10.1016/j.waojou.2020.100247 [abstract]

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Reactions 14 Nov 2020 No. 1830