Foley R J, Reeves W B
Am J Kidney Dis. 1985 Feb;5(2):132-5. doi: 10.1016/s0272-6386(85)80010-x.
Our recent experience with membrane reactions in three hemodialysis patients is reported. We believe that two distinct populations manifest this reaction. First, well-known chronic hemodialysis patients may be exposed to inadequately rinsed new membranes. The etiology may be related to ethylene oxide either as a direct toxin or as a hapten attached to serum proteins. Adequate attention to dialysis membrane priming should eliminate this particular reaction. In the second group, the patients are new to the unit (transients) and frequently arrive with little information on prior care. Two of our patients and at least one other in the literature demonstrate markedly elevated IgE levels. This suggests an IgE-mediated mechanism; whether this is related to the membrane type, ethylene oxide, or a currently undetermined allergen remains uncertain.
本文报告了我们最近在三名血液透析患者中观察到的膜反应情况。我们认为有两类不同人群会出现这种反应。首先，知名的慢性血液透析患者可能接触到冲洗不充分的新透析膜。其病因可能与环氧乙烷有关，环氧乙烷既可能是直接毒素，也可能是附着在血清蛋白上的半抗原。对透析膜预充给予充分关注应能消除这种特定反应。在第二类患者中，他们是新进入该科室的（临时患者），且前来时往往很少提供既往治疗信息。我们的两名患者以及文献中至少另外一名患者显示出IgE水平显著升高。这提示存在IgE介导的机制；但这是否与透析膜类型、环氧乙烷或目前尚未确定的过敏原有关仍不确定。
