Shelley W B, Saÿen J J
J Am Acad Dermatol. 1982 Nov;7(5):674-7. doi: 10.1016/s0190-9622(82)70150-1.
A rare complication of subcutaneous heparin therapy is reported in a 75-year-old man. Large erythematous tender plaque developed in the skin overlying the injection sites. In one area of the abdomen, frank necrosis occurred with subsequent eschar formation. Skin testing with five brands of heparin revealed that the patient had a delayed type of hypersensitivity to heparin. In contrast to coumarin necrosis, heparin necrosis is felt to be a thrombotic phenomenon resulting from immunologically induced platelet aggregation in heparin-sensitive patients. Thrombocytopenia is usually present. The diagnosis can be confirmed by platelet aggregometry and calls for immediate cessation of the heparin injections.
据报道，一名75岁男性出现了皮下肝素治疗罕见的并发症。在注射部位上方的皮肤出现大片红斑性压痛斑块。在腹部的一个区域，出现了明显的坏死，随后形成焦痂。对五个品牌的肝素进行皮肤试验显示，该患者对肝素存在迟发型超敏反应。与香豆素坏死不同，肝素坏死被认为是一种血栓形成现象，是由肝素敏感患者免疫诱导的血小板聚集所致。通常会出现血小板减少症。可通过血小板聚集测定法确诊，确诊后需立即停止肝素注射。
