Hypersensitivity reactions to modern antiplatelet and anticoagulant drugs

Scherer, Kathrin

doi:10.1007/s40629-015-0048-2

Cited by 32 publications

(37 citation statements)

References 54 publications

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“…The newest member of the P2Y12 inhibitors is ticagrelor, which is not a thienopyridine and, however, demonstrates a superior pharmacological profile than clopidogrel. In contrast to clopidogrel and prasugrel, it does not require metabolic activation and binds reversibly to the P2Y12 receptor [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Ticagrelor-Induced Angioedema: A Rare and Unexpected Phenomenon

Seecheran

Persad

et al. 2017

Case Reports in Cardiology

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Angioedema can cause potentially life-threatening airway obstruction. This case report describes an exceedingly rare episode of ticagrelor-induced hypersensitivity reaction, manifesting as angioedema with periorbital and likely respiratory involvement. The heart team should be vigilant for this precarious condition which may require emergent airway management. Desensitization protocols and alternative regimens (e.g., clopidogrel, prasugrel, and addition of an adjunctive anticoagulant) should be considered when there is an absolute indication for antiplatelet therapy.

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Section: Introductionmentioning

confidence: 99%

Ticagrelor-Induced Angioedema: A Rare and Unexpected Phenomenon

Seecheran

Persad

et al. 2017

Case Reports in Cardiology

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“…Due to their structural differences they may be additional alternatives for patients with a heparin allergy [26]. …”

Section: Discussionmentioning

confidence: 99%

Immediate Type Hypersensitivity to Heparins: Two Case Reports and a Review of the Literature

Cesana¹,

Scherer²,

Bircher³

2016

Int Arch Allergy Immunol

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Immediate type hypersensitivity reactions due to heparins are rare, and the exact immunologic pathomechanism has not been identified so far. In our 2 case reports, we describe first a 50-year-old female who received dalteparin (Fragmin®) and developed signs of an immediate type hypersensitivity reaction. The personal history revealed a previous application of dalteparin (Fragmin®). Evaluation with a skin prick test showed positive results for dalteparin. The second case deals with a 73-year-old female with a suspected immediate type reaction after the administration of dalteparin (Fragmin®). A skin prick test was negative but intracutaneous tests showed a positive reaction to the causative agent. Both cases indicated cross-reactivity reactions for low-molecular-weight heparin (LMWH) but not for unfractioned heparin (UFH) or fondaparinux. In conclusion, our case reports including a review of published cases of immediate type hypersensitivity reactions after the application of heparins illustrate this rare complication. Mostly, the causative agent can be identified with a skin test, which is highly suggestive of an IgE-mediated reaction. Therapeutic alternatives for patients with sensitization to an LMWH are UFH and fondaparinux. Both agents have a small risk of cross-reactivity compared to heparins of the same substance class.

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“…Schwere Überempfindlichkeitsreaktionen durch Ticagrelor wurden bisher sehr selten beschrieben [5]. Die klinische Manifestation ist sehr variabel.…”

Section: Diskussionunclassified