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对聚砜膜透析器的过敏反应伪装成感染。

Allergic reaction to polysulphone membrane dialyser masquerading as infection.

作者信息

Mukaya Japheth E, Jacobson Mitchell S, Esprit Don, Ajayi Tokunbo

机构信息

North Shore Medical Center, Salem, Massachusetts, USA.

出版信息

BMJ Case Rep. 2015 Feb 18;2015:bcr2014208591. doi: 10.1136/bcr-2014-208591.

Abstract

Hypersensitivity reactions during haemodialysis are well documented in the literature. Most dialysis membrane reactions occur with ethylene oxide or non-biocompatible membranes and less frequently with biocompatible membranes. The symptoms are non-specific except for the temporal relationship typically occurring during the haemodialysis. Patients who present with the non-classic type of reaction pose a diagnostic challenge and clinicians must have a high index of suspicion. We present a non-classic presentation of a hypersensitivity reaction to a polysulfone membrane dialyser with recurrent fevers during and after haemodialysis, initially thought to be due to infection. After a series of negative work ups for infection, dialysis membrane reaction was considered and the patient improved after change of the membrane.

摘要

血液透析期间的过敏反应在文献中有充分记载。大多数透析膜反应发生于环氧乙烷或非生物相容性膜,而生物相容性膜引发的反应较少见。除了通常在血液透析期间出现的时间关系外,症状并无特异性。出现非典型反应类型的患者诊断具有挑战性,临床医生必须保持高度怀疑。我们报告了一例对聚砜膜透析器过敏反应的非典型病例,患者在血液透析期间及之后反复发热,最初认为是感染所致。在一系列感染相关检查结果均为阴性后,考虑为透析膜反应,更换透析膜后患者病情改善。

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Delayed near-fatal anaphylactic reaction induced by the F10-HPS polysulphone haemodialyser.
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引用本文的文献

本文引用的文献

1
Pyrexia of unknown origin in a haemodialysis patient.一名血液透析患者的不明原因发热。
NDT Plus. 2008 Apr;1(2):109-111. doi: 10.1093/ndtplus/sfm045. Epub 2008 Jan 19.
6
Ethylene oxide allergy in dialysis patients.
Nephrol Dial Transplant. 1997 Jul;12(7):1461-3. doi: 10.1093/ndt/12.7.1461.
7
Membranes for dialysis.透析用膜
Nephrol Dial Transplant. 1995;10 Suppl 3:39-45. doi: 10.1093/ndt/10.supp3.39.
8
Hypersensitivity to hemodialysis: the United Kingdom experience.
Artif Organs. 1987 Apr;11(2):87-9. doi: 10.1111/j.1525-1594.1987.tb02634.x.
10
Allergy to dialysis materials.对透析材料过敏。
Nephrol Dial Transplant. 1989;4(7):646-52.

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