{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:23:07Z","timestamp":1767651787981,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T00:00:00Z","timestamp":1489449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Heparins are widely used for the prophylaxis\/treatment of thromboembolic events. As adverse effects, heparin\u2010induced skin lesions occur frequently (in 7.5\u201339% of patients). Skin lesions may be the only clinical manifestation of life\u2010threatening immune\u2010mediated heparin\u2010induced thrombocytopenia, but are commonly caused by a delayed\u2010type hypersensitivity response [heparin\u2010induced delayed\u2010type hypersensitivity (<jats:styled-content style=\"fixed-case\">HIHS<\/jats:styled-content>)]. Risk factors have not been prospectively identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify possible risk factors for heparin\u2010induced skin lesions from three independent clinical trials in a combined analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A pooled analysis from prospective studies was performed, and possible risk factors were included in a multiple logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Obesity (body mass index of &gt;\u200925), prolonged anticoagulant therapy, prior heparin exposure and younger age (&lt;\u200955\u2009years) were confirmed as independent risk factors for <jats:styled-content style=\"fixed-case\">HIHS<\/jats:styled-content>. The choice of anticoagulant preparation had the greatest influence. On comparison of dalteparin, enoxaparin, fondaparinux, unfractionated heparin, and nadroparin, the latter was associated with the highest risk of eliciting <jats:styled-content style=\"fixed-case\">HIHS<\/jats:styled-content> (odds ratio of 30.2, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 11.7\u201377.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high risk associated with nadroparin has been validated in controlled trials, and this emphasizes the singularity of each heparin preparation in terms of allergenicity and that individualized anticoagulation is required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.12764","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T20:58:22Z","timestamp":1489525102000},"page":"35-41","source":"Crossref","is-referenced-by-count":8,"title":["Nadroparin carries a potentially high risk of inducing cutaneous delayed\u2010type hypersensitivity responses"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4597-0759","authenticated-orcid":false,"given":"Marc","family":"Schindewolf","sequence":"first","affiliation":[{"name":"Division of Haemostaseology, Department of Internal Medicine Goethe University Hospital  60590 Frankfurt am Main Germany"},{"name":"Division of Vascular Medicine, Swiss Cardiovascular Centre University Hospital Bern  3010 Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Recke","sequence":"additional","affiliation":[{"name":"Department of Dermatology and L\u00fcbeck Institute of Experimental Dermatology University of L\u00fcbeck  23538 L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlef","family":"Zillikens","sequence":"additional","affiliation":[{"name":"Department of Dermatology and L\u00fcbeck Institute of Experimental Dermatology University of L\u00fcbeck  23538 L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edelgard","family":"Lindhoff\u2010Last","sequence":"additional","affiliation":[{"name":"Division of Haemostaseology, Department of Internal Medicine Goethe University Hospital  60590 Frankfurt am Main Germany"},{"name":"Agaplesion Bethanien Hospital, Cardiovascular Centre Bethanien (CCB)  60389 Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf J.","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Department of Dermatology and L\u00fcbeck Institute of Experimental Dermatology University of L\u00fcbeck  23538 L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0689"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0960-135X.2005.01452.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60409-7"},{"key":"e_1_2_6_5_1","first-page":"213","article-title":"Clinical and coagulation\u2010physiological studies on a new heparin depot preparation","volume":"150","author":"Plancherel P","year":"1953","journal-title":"Z Klin Med"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161208786369768"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mbc.0000198992.18384.5a"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1160\/TH06-04-0210","article-title":"Management of cutaneous type IV hypersensitivity reactions 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