Document Detail


Cryofiltration apheresis and plasma fractionation causing anaphylactoid reactions in patients receiving angiotensin converting enzyme inhibitors.
MedLine Citation:
PMID:  10225724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe anaphylactoid reactions and even death have been reported in hemodialysis patients using certain membrane dialyzers while receiving angiotensin converting enzyme (ACE) inhibitors. We report mild to moderate anaphylactoid reactions in 4 patients receiving plasmapheresis with on-line membrane filters after being placed on ACE inhibitors. Of 21 patients receiving 497 plasma fractionation procedures, only the 2 patients who were receiving ACE inhibitors developed anaphylactoid reactions. Of 28 patients who had 680 cryofiltration procedures, only 2 of 5 patients who were taking ACE inhibitors developed anaphylactoid reactions. All patients developed facial flushing, increased warmth, bradycardia, and hypotension after approximately 1/2 to 1 L of plasma was processed during the procedures. Only a few procedures caused severe hypotension requiring discontinuation of the procedure. We quantified vasodilatory mediators in 1 patient, who developed pronounced symptoms. Results were obtained for 6-keto PGF1alpha, PGD-M, and methyl histamine in plasma. In addition, in the same patient, 2,3 dinor 6-keto PGF1alpha and methyl histamine were quantified in urine samples. Our results showed that plasma and urinary metabolites were not grossly elevated although they did increase slightly. Mild to moderate anaphylactoid reactions were observed in some patients on ACE inhibitors receiving plasma fractionation or cryofiltration apheresis. This was resolved by discontinuing either the ACE inhibitor, plasma fractionation, or cryofiltration apheresis.
Authors:
G A Siami; F S Siami; J D Morrow; W J Stone
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis     Volume:  1     ISSN:  1091-6660     ISO Abbreviation:  Ther Apher     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1999-05-13     Completed Date:  1999-05-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9706703     Medline TA:  Ther Apher     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  325-9     Citation Subset:  IM    
Affiliation:
Veterans Administration Medical Center and Vanderbilt University Department of Medicine, Nashville, Tennessee 37212-2637, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anaphylaxis / etiology*
Angiotensin-Converting Enzyme Inhibitors / adverse effects*
Cell Fractionation
Female
Humans
Male
Middle Aged
Plasmapheresis / adverse effects*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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