Extensive arm skin necrosis following administration of unfractionated heparin

Dena Firouzabadi; Peyman Petramfar; Laleh Mahmoudi

doi:10.4103/ijp.ijp_311_23

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$Extensive arm skin necrosis following administration of unfractionated heparin$

Journal article

Peer reviewed

Extensive arm skin necrosis following administration of unfractionated heparin

Dena Firouzabadi, Peyman Petramfar and Laleh Mahmoudi

Indian journal of pharmacology, Vol.55(5), pp.332-334

09/01/2023

DOI: 10.4103/ijp.ijp_311_23

PMCID: PMC10751520

PMID: 37929412

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Abstract

Unfractionated heparin (UH), a commonly used anticoagulant, can rarely cause skin necrosis following heparin-induced thrombocytopenia (HIT). A 38-year-old female, a case of chronic inflammatory demyelinating polyneuropathy (CIDP) admitted to the neurology ward, developed extensive skin necrosis following a change in UH dose at the exact site of UH injection. A sudden fall in the platelet count was observed within 48 h of increasing the UH dose. Necrosis of the outer layer of the skin along with clot formation and inflammation in the inner layers was detected after histopathological evaluation. UH was discontinued, and rivaroxaban was started for the patient as soon as the complication was detected. The patient was discharged in good condition after completing treatment for CIDP without any need for surgical removal of the necrotic tissue. Extensive skin necrosis, as a result of HIT, requires immediate discontinuation of UH and substitution of a nonheparin-based anticoagulation treatment.

Adult

Anticoagulants - adverse effects

Arm

Female

Heparin - adverse effects

Humans

Necrosis - chemically induced

Necrosis - drug therapy

Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - drug therapy

Thrombocytopenia - chemically induced

Thrombocytopenia - drug therapy

Details

Title: Subtitle: Extensive arm skin necrosis following administration of unfractionated heparin
Creators: Dena Firouzabadi - Shiraz University of Medical Sciences
Peyman Petramfar - Shiraz University of Medical Sciences
Laleh Mahmoudi - Shiraz University of Medical Sciences
Resource Type: Journal article
Publication Details: Indian journal of pharmacology, Vol.55(5), pp.332-334
DOI: 10.4103/ijp.ijp_311_23
PMID: 37929412
PMCID: PMC10751520
NLM abbreviation: Indian J Pharmacol
ISSN: 0253-7613
eISSN: 1998-3751
Language: English
Date published: 09/01/2023
Academic Unit: Neurology
Record Identifier: 9985013730302771

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