Hill Amanda, Williams Charlotte, Finucane Katherine, Carson Naomi, Neuberger Francesca, Xie Fangyi
Women's and Children's Department, North Bristol NHS Trust, Bristol, UK.
Department of Dermatology, North Bristol NHS Trust, Bristol, UK.
Obstet Med. 2025 Feb 13:1753495X251317303. doi: 10.1177/1753495X251317303.
Low molecular weight heparin (LMWH) is a common agent given in pregnancy; however, cutaneous drug reactions with its use in pregnancy are rarely reported. The case describes a 30-year-old woman with stable Crohn's disease on ustekinumab presenting with a rash at prophylactic LMWH injection sites 30 weeks into her third pregnancy. Skin biopsy reported appearance consistent with an urticarial drug hypersensitivity reaction. A combination of steroid treatment, topical emollient and cessation of LMWH resulted in resolution of symptoms over 2 weeks. Postnatal venous thromboembolism prophylaxis with fondaparinux was uncomplicated. Overall, this case highlights the importance of reporting drug reactions in pregnancy. It additionally exposes a gap in research surrounding immunomodulators and heparins in the development of cutaneous reactions in pregnancy.
低分子量肝素（LMWH）是孕期常用药物；然而，关于其在孕期使用时发生皮肤药物反应的报道很少。该病例描述了一名30岁患有稳定克罗恩病且正在使用乌司奴单抗的女性，在其第三次妊娠30周时，预防性注射LMWH的部位出现皮疹。皮肤活检报告显示外观符合荨麻疹药物超敏反应。类固醇治疗、局部润肤剂和停用LMWH的联合治疗使症状在2周内得到缓解。产后使用磺达肝癸钠预防静脉血栓栓塞症未出现并发症。总体而言，该病例突出了报告孕期药物反应的重要性。此外，它还揭示了在孕期皮肤反应发生过程中，围绕免疫调节剂和肝素的研究存在空白。
