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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Complement Activation and Hypersensitivity Reactions to Dialysis Membranes
New England Journal of Medicine, Volume 311, No. 14, Year 1984
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Description
Certain patients receiving hemodialysis experience recurrent chest pain, dyspnea, and hypotension during exposure to new cuprophane-membrane dialyzers (the “first-use syndrome”). Because activation of complement may be involved in these events, we examined in vivo complement activation with new cuprophane membranes and in vitro activation by zymosan in 6 such patients, and compared them with 10 patients who did not have symptoms during dialysis. All patients with the first-use syndrome had maximal complement activation 10 minutes after initiation of dialysis, with C3a des-arginine (desArg), the stable metabolite of C3 activation, equal to 8533±157 ng per milliliter (mean ±S.E.M.). In asymptomatic patients the maximal C3a desArg value occurred at 15 minutes and was only 2907±372 ng per milliliter (P≤0.0001). At a concentration of 3.8X10–5 g of zymosan per milliliter, patients with the first-use syndrome had a C3a desArg level of 29.6±1.4 μg per milliliter, whereas it was only 16.6±2.3 μg per milliliter in asymptomatic patients (P≤0.0001). Two other patients, who experienced cardiopulmonary collapse during the first two minutes of dialysis, had a C3a desArg level of 18,900 and 7800 ng per milliliter, respectively. We conclude that the occurrence of adverse symptoms associated with new cuprophane-membrane dialyzers correlates with complement activation. © 1984, Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Lazarus, John Michael
United States, Boston
Harvard Medical School
United States, Wilmington
Dupont
United States, Ann Arbor
University of Michigan, Ann Arbor
Port, Friedrich K.
United States, Boston
Harvard Medical School
United States, Wilmington
Dupont
United States, Ann Arbor
University of Michigan, Ann Arbor
Statistics
Citations: 328
Authors: 2
Affiliations: 3
Identifiers
Doi:
10.1056/NEJM198410043111403
ISSN:
00284793
Research Areas
Noncommunicable Diseases