Mukaya Japheth E, Jacobson Mitchell S, Esprit Don, Ajayi Tokunbo
North Shore Medical Center, Salem, Massachusetts, USA.
BMJ Case Rep. 2015 Feb 18;2015:bcr2014208591. doi: 10.1136/bcr-2014-208591.
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.
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。