Asia Pac Allergy.  2013 Oct;3(4):285-288. 10.5415/apallergy.2013.3.4.285.

Recurrent intradialytic heparin induced anaphylaxis: workup and management

• Santosa A
• Tan SH
• Cheng YK

• KMID: 2397306
• DOI: http://doi.org/10.5415/apallergy.2013.3.4.285

Abstract

Heparin has been widely used for intradialytic anticoagulation since the 1940s. Heparin induced anaphylaxis can be life threatening, mandating early recognition and intervention. However, due to its relative rarity many physicians remain unaware. We report the case of a 70-year-old woman requiring dialysis, who developed recurrent anaphylaxis to intradialytic heparin. We describe a systematic approach to confirm the suspected heparin allergy, which must include an evaluation of predisposing factors, the dialysis equipment and concomitant medications. Further workup for safe alternatives employing skin prick and intradermal tests, as well as provocation tests are discussed.

Keyword

Dialysis; Heparin; Anaphylaxis; Skin tests; Intradermal test; Drug hypersensitivity

MeSH Terms

Aged
Anaphylaxis*
Causality
Dialysis
Drug Hypersensitivity
Female
Heparin*
Humans
Hypersensitivity
Intradermal Tests
Skin
Skin Tests
Heparin

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