Olafiranye Feyisayo, Kyaw Win, Olafiranye Oladipupo
Department of Family Medicine, State University of New York Downstate Medical Center, 450 Clarkson Avenue, P.O. Box 1199, Brooklyn, NY 11203-2098, USA.
Case Rep Med. 2011;2011:134295. doi: 10.1155/2011/134295. Epub 2011 Apr 10.
Blood and dialyzer membrane interaction can cause significant thrombocytopenia through the activation of complement system. The extent of this interaction determines the biocompatibility of the membrane. Although the newer synthetic membranes have been shown to have better biocompatibility profile than the cellulose-based membranes, little is known about the difference in biocompatibility between synthetic membrane and modified cellulose membrane. Herein, we report a case of a patient on hemodialysis who developed dialyzer-membrane-related thrombocytopenia with use of synthetic membrane (F200NR polysulfone). The diagnosis of dialyzer membrane-associated thrombocytopenia was suspected by the trend of platelet count before and after dialysis, and the absence of other possible causes of thrombocytopenia. We observed significant improvement in platelet count when the membrane was changed to modified cellulose membrane (cellulose triacetate). In patients at high risk for thrombocytopenia, the modified cellulose membrane could be a better alternative to the standard synthetic membranes during hemodialysis.
血液与透析器膜的相互作用可通过补体系统的激活导致显著的血小板减少。这种相互作用的程度决定了膜的生物相容性。尽管已证明新型合成膜比纤维素基膜具有更好的生物相容性,但对于合成膜与改性纤维素膜之间生物相容性的差异知之甚少。在此,我们报告一例血液透析患者使用合成膜(F200NR聚砜)后发生透析器膜相关血小板减少的病例。透析器膜相关血小板减少症的诊断通过透析前后血小板计数的趋势以及不存在其他可能导致血小板减少的原因来怀疑。当更换为改性纤维素膜(三醋酸纤维素)时,我们观察到血小板计数有显著改善。对于有血小板减少高风险的患者,在血液透析期间,改性纤维素膜可能是标准合成膜的更好替代品。