Non-immediate allergic cutaneous reactions to heparins have been increasingly reported, typically manifesting as large, eczematous plaques at sites of subcutaneous injection. Patients may demonstrate cross-reactivity between unfractionated heparin, low molecular weight heparin and semi-synthetic heparinoids, making finding an alternative difficult. Fondaparinux has been identified as a useful alternative in such patients; here we present the first two documented cases in Australia and a literature review.
Keywords: anticoagulation; hypersensitivity; immunology; low molecular weight heparin; unfractionated heparin; venous thromboembolism.
© 2018 Royal Australasian College of Physicians.