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Erschienen in: CEN Case Reports 1/2015

01.05.2015 | Case Report

A case of anaphylactoid reaction to acetate in acetate-containing bicarbonate dialysate

verfasst von: Taro Misaki, Yumiko Suzuki, Yoshitaka Naito, Tempei Shiooka, Taisuke Isozaki

Erschienen in: CEN Case Reports | Ausgabe 1/2015

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Abstract

A 35-year-old man with end-stage kidney disease due to chronic glomerulonephritis was admitted to our hospital to start maintenance hemodialysis (HD). One hour after starting the first session of HD, he experienced general pruritus, urticaria, and dyspnea. Signs and symptoms were resolved by discontinuing HD and administrating an antihistamine drug; HD-associated anaphylactoid reactions were therefore suspected. Over the next few HD sessions, we changed the dialysis membrane, anticoagulant, HD circuit and needle, in that order, but general pruritus and urticaria again appeared within 3 h after starting each session of HD. Finally, when we changed the dialysate from acetate-containing bicarbonate dialysate to acetate-free bicarbonate dialysate, urticaria was clearly less than that seen in previous HD sessions, and subsided after discontinuation of HD. Subsequently, 20 mg of oral prednisolone (PSL) was administered 1 h before starting HD, and the patient did not experience general pruritus, urticaria, or dyspnea after starting the session. When administered acetate-containing bicarbonate dialysate after oral PSL pretreatment, the patient again experienced general pruritus, urticaria and dyspnea. Few reports have been published on the occurrence of anaphylactoid reactions during HD using acetate dialysate. We report a rare case of anaphylactoid reactions with acetate in acetate-containing bicarbonate dialysate that were reduced with the use of acetate-free bicarbonate dialysate and oral PSL pretreatment.
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Metadaten
Titel
A case of anaphylactoid reaction to acetate in acetate-containing bicarbonate dialysate
verfasst von
Taro Misaki
Yumiko Suzuki
Yoshitaka Naito
Tempei Shiooka
Taisuke Isozaki
Publikationsdatum
01.05.2015
Verlag
Springer Japan
Erschienen in
CEN Case Reports / Ausgabe 1/2015
Elektronische ISSN: 2192-4449
DOI
https://doi.org/10.1007/s13730-014-0144-z

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