RUSH DESENSITIZATION IN HEPARIN HYPERSENSITIVITY - A CASE-REPORT

Among all the known drug intolerances, adverse reactions to heparin ar e not very common. No desensitization in patients with heparin hyperse nsitivity has ever been attempted. We report the case of a 55-year-old female patient with mitral stenosis and insufficiency, and tricuspid and aortic insufficiency. The patient underwent heparin treatment, and urticaria occurred with either s.c. calcium heparin or i.v. sodium he parin. Allergy testing (skin tests and patch tests) was negative. A ps eudoallergic intolerance was diagnosed. Mitral valve replacement with the extracorporeal circulation method was necessary; therefore, hepari n treatment was administered. A heparin rush desensitization together with antihistamine drugs (4 mg clorpheniramine maleate for 3 d) was st arted: 50 UI (0.5 mg) s.c. sodium heparin were first administered; wit hin 4 d, 5000 UI (50 mg) sodium heparin was administered i.v. with no side-effects. A full-dosage heparin treatment was then administered an d heart surgery was easily performed. During the postsurgical course, i.v. sodium heparin was smoothly replaced with s.c. calcium heparin (2 5000 UI s.c. per day) and with oral anticoagulants (sodium warfarin).