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Heparin Sensitivity: Report of a Case

Heparin Sensitivity: Report of a Case Abstract True immunologic hypersensitivity reactions to heparin are very uncommon. In 1956, Bernstein described a patient with anaphylaxis to bovine heparin.1 He reviewed the literature, which then contained 32 reports of heparin sensitivity. Of these 32 cases, seven patients had evidence of anaphylaxis following heparin administration. This report deals with an apparent hypersensitivity reaction to bovine heparin in the absence of dermal reactivity, but in which serum from the patient demonstrated precipitating antibody to bovine and not porcine heparin. Patient Summary A 64-year-old retired serviceman sustained a pulmonary thromboembolism during hospitalization for a possible myocardial infarction. A therapeutic course of bovine heparin was started. There was no history of either allergic diathesis or drug allergy. Initially, 7,000 units of heparin were administered intravenously. About one hour later, the patient experienced the sudden onset of shaking chills associated with a temperature of 37.8 C, which lasted ten minutes. Neither bronchospasm nor References 1. Bernstein IL: Anaphylaxis to heparin sodium, report of a case, with immunologic studies. JAMA 161:1379-1381, 1956.Crossref 2. Farr RS: A quantitative immunochemical measure of the primary interaction between I*BSA and antibody. J Infect Dis 103:239-262, 1958.Crossref 3. Carr RI, Wold RT, Farr RS: Antibodies to bovine gamma globulin (BGG) and the occurrence of a BGG-like substance in systemic lupus erythematosus sera. J Allergy Clin Immunol 50:18-30, 1972.Crossref 4. Dolowitz DA, Dougherty TF: The use of heparin as an anti-inflammatory agent. Laryngoscope 70:873-884, 1960. 5. Keller R: Zur bindung von histamin und serotonin in den Matzellen. Arzneim Forsch 8:390-394, 1958. 6. Gertz H, et al: Histamine liberating and anticoagulant activity of heparin released in anaphylactic shock in the guinea pig. Int Arch Allergy Appl Immunol 33:306-319, 1968.Crossref 7. Ten Pas A, Monto RW: The treatment of autoimmune hemolytic anemia with heparin. Am J Med Sci 251:63-69, 1966.Crossref 8. Ecker EE, Pillemer L: Anticoagulants and complementary activity: An experimental study. J Immunol 40:73-80, 1941. 9. Bardana EJ, et al: The use of heparin in autoimmune hemolytic disease. Blood 35:377-385, 1970. 10. Bardana EJ, Edwards MJ, Pirofsky B: Heparin as treatment for bronchospasm for asthma. Ann Allergy 27:108-113, 1969. 11. Gell PGH, Coombs RRA: Clinical Aspects of Immunology . Oxford, Blackwell, 1968. 12. Zinn WJ: Side reactions of heparin in clinical practice. Am J Cardiol 14:36-38, 1964.Crossref 13. Minden P, Anthony BF, Farr RS: A comparison of seven procedures to detect the primary binding of antigen by antibody. J Immunol 102:832-841, 1969. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Heparin Sensitivity: Report of a Case

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Publisher
American Medical Association
Copyright
Copyright © 1973 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1973.03650110080017
Publisher site
See Article on Publisher Site

Abstract

Abstract True immunologic hypersensitivity reactions to heparin are very uncommon. In 1956, Bernstein described a patient with anaphylaxis to bovine heparin.1 He reviewed the literature, which then contained 32 reports of heparin sensitivity. Of these 32 cases, seven patients had evidence of anaphylaxis following heparin administration. This report deals with an apparent hypersensitivity reaction to bovine heparin in the absence of dermal reactivity, but in which serum from the patient demonstrated precipitating antibody to bovine and not porcine heparin. Patient Summary A 64-year-old retired serviceman sustained a pulmonary thromboembolism during hospitalization for a possible myocardial infarction. A therapeutic course of bovine heparin was started. There was no history of either allergic diathesis or drug allergy. Initially, 7,000 units of heparin were administered intravenously. About one hour later, the patient experienced the sudden onset of shaking chills associated with a temperature of 37.8 C, which lasted ten minutes. Neither bronchospasm nor References 1. Bernstein IL: Anaphylaxis to heparin sodium, report of a case, with immunologic studies. JAMA 161:1379-1381, 1956.Crossref 2. Farr RS: A quantitative immunochemical measure of the primary interaction between I*BSA and antibody. J Infect Dis 103:239-262, 1958.Crossref 3. Carr RI, Wold RT, Farr RS: Antibodies to bovine gamma globulin (BGG) and the occurrence of a BGG-like substance in systemic lupus erythematosus sera. J Allergy Clin Immunol 50:18-30, 1972.Crossref 4. Dolowitz DA, Dougherty TF: The use of heparin as an anti-inflammatory agent. Laryngoscope 70:873-884, 1960. 5. Keller R: Zur bindung von histamin und serotonin in den Matzellen. Arzneim Forsch 8:390-394, 1958. 6. Gertz H, et al: Histamine liberating and anticoagulant activity of heparin released in anaphylactic shock in the guinea pig. Int Arch Allergy Appl Immunol 33:306-319, 1968.Crossref 7. Ten Pas A, Monto RW: The treatment of autoimmune hemolytic anemia with heparin. Am J Med Sci 251:63-69, 1966.Crossref 8. Ecker EE, Pillemer L: Anticoagulants and complementary activity: An experimental study. J Immunol 40:73-80, 1941. 9. Bardana EJ, et al: The use of heparin in autoimmune hemolytic disease. Blood 35:377-385, 1970. 10. Bardana EJ, Edwards MJ, Pirofsky B: Heparin as treatment for bronchospasm for asthma. Ann Allergy 27:108-113, 1969. 11. Gell PGH, Coombs RRA: Clinical Aspects of Immunology . Oxford, Blackwell, 1968. 12. Zinn WJ: Side reactions of heparin in clinical practice. Am J Cardiol 14:36-38, 1964.Crossref 13. Minden P, Anthony BF, Farr RS: A comparison of seven procedures to detect the primary binding of antigen by antibody. J Immunol 102:832-841, 1969.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1973

References