Kammerl M C, Schaefer R M, Schweda F, Schreiber M, Riegger G A, Krämer B K
Klinik und Poliklinik für Innere Medizin II, Universität, Regensburg, Germany.
Clin Nephrol. 2000 Jun;53(6):486-8.
The negatively charged membrane AN69 is known to evoke anaphylactoid reactions both without and with concomitant ACE inhibition. Underlying reasons are mainly the induction of bradykinin release due to the negatively charged membrane and the reduced degradation of bradykinin due to ACE inhibition. This complication has been reported repeatedly, but anaphylactoid reactions still occur in clinical practice. We recently had to treat two patients who suffered anaphylactoid reactions during extracorporal therapy with an AN69 membrane and simultaneous ACE inhibition. The first incident occurred in a patient on hemodialysis, the second was in a patient on continuous venovenous hemofiltration. An anaphylactoid reaction induced by an AN69 membrane during continuous, extracorporal treatment in combination with ACE inhibition has not been reported so far. Our report intends to serve as a reminder that the potentially lethal combination of AN69 membranes with ACE inhibitor treatment should be avoided.
已知带负电荷的膜AN69在无ACE抑制和有ACE抑制伴随的情况下均可引发类过敏反应。其根本原因主要是带负电荷的膜诱导缓激肽释放，以及ACE抑制导致缓激肽降解减少。这种并发症已被多次报道，但在临床实践中类过敏反应仍会发生。我们最近不得不治疗两名在使用AN69膜进行体外治疗并同时进行ACE抑制时发生类过敏反应的患者。第一起事件发生在一名血液透析患者身上，第二起发生在一名持续静静脉血液滤过患者身上。迄今为止，尚未有关于在连续体外治疗期间AN69膜联合ACE抑制引发类过敏反应的报道。我们的报告旨在提醒人们应避免AN69膜与ACE抑制剂治疗这一潜在致命组合。
