Summary
Objectives. The aim of this work is to review the newest high-quality studies analysing heparin-induced immune system-related adverse reactions.
Methods. For the literature search, Pubmed and Scopus databases were used. Only articles published in English between 2008 and 2023, describing original research were included (review articles were excluded from the search). Subsequently, additional measures were taken to find the subset of studies of the highest reliability and quality, for that, cut-off values for journal impact factor and the number of times a certain study was cited were used. An additional literature search was done to find additional information for introduction as well as regarding differential diagnostics of the immune system-related adverse reactions caused by heparins.
Results. 32 studies describing a broad range spectrum of adverse effects induced by heparins were found. Heparins can cause alpha-gal reactions, immediate- type allergic reactions (including anaphylactic and anaphylactoid reactions), delayed-type allergic reactions, skin lesions and heparin-induced thrombocytopenia. Interestingly, the use of heparins negatively correlates with the risk of chronic itch. Selected publications often find that nadroparin is associated with the highest risk of adverse reactions, while fondaparinux is often identified as a safe alternative in cases of adverse reactions caused by heparins. In cases of heparin-induced thrombocytopenia, it was observed that low molecular weight heparins are less likely to cause thrombocytopenia than unfractionated heparin and argatroban was identified as a safe alternative in such cases. When prescribing heparins, it is important to carefully analyse the patient’s medical history, choose medications that are the safest options statistically, and, if needed, perform allergy tests.
