Ebo D G, Bosmans J L, Couttenye M M, Stevens W J
Department of Immunology, Allergology and Rheumatology, University Antwerpen, UA, Campus Drie Eiken, Antwerpen, Belgium.
Allergy. 2006 Feb;61(2):211-20. doi: 10.1111/j.1398-9995.2006.00982.x.
Anaphylactic and anaphylactoid reactions related to haemodialysis have been increasingly described for almost 3 decades. The majority of these cases used to occur with ethylene oxide sterilized, and complement-activating cellulose membranes. However, a considerable number of publications have focused on polyacrylonitrile AN69 high flux membranes, angiotensin converting enzyme inhibitors and iron as other important causes of potentially severe haemodialysis-related anaphylactoid reactions. Clinical manifestations vary considerably and generally do not allow differentiation between IgE-mediated anaphylaxis and anaphylactoid reactions (e.g. from nonspecific mediator release). Successful management of these patients requires multidisciplinary approach and involves prompt recognition and treatment by the attending physician, and identification of the offending agent(s) with subsequent avoidance of the incriminated compound(s). This review focuses on some major causes of anaphylactoid and anaphylactic reactions during haemodialysis. Special consideration is given to the therapeutic and diagnostic approach.
近三十年来，与血液透析相关的过敏反应和类过敏反应的报道日益增多。这些病例大多发生在使用环氧乙烷灭菌且能激活补体的纤维素膜时。然而，大量出版物关注的是聚丙烯腈AN69高通量膜、血管紧张素转换酶抑制剂和铁，它们是潜在严重血液透析相关类过敏反应的其他重要原因。临床表现差异很大，通常无法区分IgE介导的过敏反应和类过敏反应（例如非特异性介质释放引起的反应）。成功管理这些患者需要多学科方法，包括主治医生的及时识别和治疗，以及识别致病因素并随后避免使用相关化合物。本综述重点关注血液透析期间类过敏反应和过敏反应的一些主要原因。特别考虑了治疗和诊断方法。
