Shahak A, Pósán E, Szücs G, Rigó J, Boda Z
2nd Department of Medicine, University Medical School, Debrecen, Hungary.
Angiology. 1996 Jul;47(7):725-7. doi: 10.1177/000331979604700715.
A severe thrombotic thrombocytopenic status, induced by heparin in a sixty-nine-year-old woman undergoing total hip joint arthroplasty, was treated by switching the anticoagulant therapy to coumarin, which induced skin necrosis. There appeared to be a possible causal relation between the severe immune reaction to heparin and the condition that predisposed to skin necrosis in the presence of coumarin. In patients who express a strong immune response to heparin, a different anticoagulant approach other than use of coumarin congeners appears to be justified.
一名69岁接受全髋关节置换术的女性患者因肝素诱发了严重的血栓性血小板减少状态，通过将抗凝治疗改为香豆素进行治疗，但这又导致了皮肤坏死。对肝素的严重免疫反应与在香豆素存在的情况下易发生皮肤坏死的状况之间似乎存在因果关系。对于对肝素表现出强烈免疫反应的患者，采用香豆素类似物以外的其他抗凝方法似乎是合理的。
