Haemodialysis in a patient with haemophilia B

phils; 0% eosinophils), haemoglobin 11.0 g/dl and platelets 202 000/mm. Blood glucose was 222mg/dl, sodium 143mEq/l, potassium 3.8mEq/l, calcium 9.6mg/l, albumin 3.4 g/dl, uric acid 6.6mg/dl, amylase 75U/L, lipase 65U/L, alanine aminotransferase (ALT) 30U/l, aspartate aminotransferase (AST) 46U/l, creatinine kinase-MB (CK-MB) 10.9U/l, troponin-I 0.13 ng/ml, C-reactive protein quantative 0.2mg/dl and IgE 344.4 IU/ml. Blood gas analysis showed pH 7.47, PaO2 80.1mmHg, O2 saturation 96.1%, and PCO2 35mmHg. Echocardiograms revealed adequate left ventricular function with mild mitral valve regurgitation. During the follow-up, regular haemodialysis was given three times a week with cellulose diacetate hollow fibre (Dicea170G, Baxter, USA), and no anaphylaxis occurred. In summary, we describe a delayed near-fatal anaphylactic reaction induced by a polysulphone haemodialyser. Although hypersensitivity to biocompatible dialysers is rare and usually occurs during initial haemodialysis, doctors and members of haemodialysis centers should keep in mind that a risk of severe anaphylaxis may occur at any time during a prolonged haemodialysis treatment.