A case in which an allergy was suspected to have been caused by a bicarbonate dialysate containing acetate

Koinuma, Kana; Kimura, Hayato; Tsukida, Mayuko; Mishima, Keiichiro

doi:10.4009/jsdt.51.545

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…We should consider the allergic reaction to acetate as the cause of recurrent fever after dialysis when using acetatecontaining bicarbonate dialysate. We found 11 case reports of hypersensitivity reactions related to acetate dialysate (summarized in Table 1) [4][5][6][7][8][9][10][11][12][13][14]. However, as seen in this case, fever is atypical, and has been reported only in two cases.…”

Section: Discussionmentioning

confidence: 89%

Hypersensitivity reactions to bicarbonate dialysate containing acetate: a case report with literature review

Nishiuchi¹,

Shima²,

Fukata

et al. 2020

CEN Case Rep

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Although hemodialysis-hypersensitivity reactions have various causes, only a few cases of hypersensitivity to acetate dialysate accompanied by fever have been reported. We present the case of a 69-year-old hemodialysis patient who was admitted due to fever after dialysis. He had undergone online hemodiafiltration using acetate-free citrate-containing dialysate. After admission, we switched to acetate-containing bicarbonate dialysate. He was diagnosed with pneumonia and treated with ceftriaxone. However, fever that occurred post dialysis persisted, displaying a gradual elevation in CRP level and eosinophils (up to 9.7 mg/dL and 3774 cells/μL, respectively). After a series of negative workups for infection and dialysis membrane allergy, we suspected that acetate-containing bicarbonate dialysate to be the cause of the allergic reaction and switched to acetate-free bicarbonate dialysate. Consequently, eosinophil count decreased and the fever abated. The drug-induced lymphocyte stimulation test finding (for acetate dialysate) was positive, and he was diagnosed with acetate dialysate-induced hypersensitivity reactions. The condition was not detected earlier due to the complications associated with pneumonia.

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Section: Discussionmentioning

confidence: 89%

Hypersensitivity reactions to bicarbonate dialysate containing acetate: a case report with literature review

Nishiuchi¹,

Shima²,

Fukata

et al. 2020

CEN Case Rep

View full text Add to dashboard Cite

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“…Diagnostic workup identified eosinophilia, which had been managed until his current admission, and the relapse of eosinophilia was considered to cause his symptoms. Many studies report allergic reaction to the dialysate, dialysis membrane, or anticoagulants 8 , 9 , 10 as a cause of eosinophilia. However, failure to resolve symptoms and eosinophilia after switching the dialysis membrane and anticoagulants led to the suspicion of renal cancer the cause.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of eosinophilia associated with dialysis‐related renal cancer with radical nephrectomy

Goto,

Tamura,

Matsuura

et al. 2024

IJU Case Reports

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IntroductionSecondary eosinophilia due to solid tumors is a rare case. This is the first study to report secondary eosinophilia due to renal cancer in a patient on dialysis.Case presentationA 70‐year‐old man, on long‐term hemodialysis was incidentally detected with right renal cancer, and workup performed revealed eosinophilia. Allergic symptoms caused by hemodialysis were initially considered; however, treatment did not lead to any improvement in eosinophilia. Therefore, nephrectomy for renal cancer was performed. The resolution of symptoms and eosinophilia after surgery suggested renal cancer as the cause of eosinophilia.ConclusionAs demonstrated in this patient with dialysis‐related renal cancer, eosinophilia associated with solid tumors may be addressed by treating the tumor.

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A case in which an allergy was suspected to have been caused by a bicarbonate dialysate containing acetate

Cited by 2 publications

References 2 publications

Hypersensitivity reactions to bicarbonate dialysate containing acetate: a case report with literature review

Hypersensitivity reactions to bicarbonate dialysate containing acetate: a case report with literature review

Successful treatment of eosinophilia associated with dialysis‐related renal cancer with radical nephrectomy

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