Ohashi N, Yonemura K, Goto T, Suzuki H, Fujigaki Y, Yamamoto T, Hishida A
First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Clin Nephrol. 2003 Sep;60(3):214-7. doi: 10.5414/cnp60214.
A 57-year-old woman was admitted because of severe bradycardia and hypotension caused by an anti-arrhythmic agent and beta-blocker. For 19 months before admission, she had been undergoing hemodialysis with an F8-HPS polysulfone membrane hemodialyzer without any complications. In 2 dialysis sessions after admission, when a BS polysulfone membrane was used, she experienced anaphylactoid shock with severe hypotension leading to syncope, dyspnea and vomiting, just after the start of hemodialysis. After the anaphylactoid shock, her dialyzer membrane was changed to a cellulose triacetate membrane and she did not suffer from such attacks. This case indicates that severe anaphylactoid shock may be caused by a biocompatible dialyzer membrane and that the reactions of patients to each polysulfone membrane may differ among polysulfone membranes made by different manufacturers.
一名57岁女性因抗心律失常药和β受体阻滞剂导致严重心动过缓和低血压而入院。入院前19个月,她一直在使用F8-HPS聚砜膜血液透析器进行血液透析,未出现任何并发症。入院后的2次透析过程中,使用BS聚砜膜时,在血液透析开始后不久,她就出现了类过敏休克,伴有严重低血压,导致晕厥、呼吸困难和呕吐。类过敏休克发生后,她的透析器膜更换为三醋酸纤维素膜,此后未再发生此类发作。该病例表明,生物相容性透析器膜可能会引起严重的类过敏休克,并且不同制造商生产的聚砜膜,患者对其反应可能存在差异。