Abstract
Marked eosinophilia induced by nafamostat mesilate (Futhan®; FUT), a serine-protease inhibitor, was recently reported in a hemodialysis patient. However the mechanism and the pattern of allergic reaction are currently unknown.
Here we report a case of a 56-year-old man on hemodialysis who showed marked eosinophilia (13000/μl) induced by FUT. According to challenge test results, the eosinophilia did not occur in the early phases of drug usage. However, marked eosinophilia developed with repetitive use of FUT. There was a positive correlation between the incidence of drug use and the eosinophil counts (Y=1.849+0.061X, R2=0.95, p<0.01). Furthermore, we investigated the relationship between eosinophilia and the serum levels of the cytokines interleukin-2 (IL-2) and interleukin-3 (IL-3) induced by hemodialysis. In this case, serum IL-2 and IL-3 levels were not increased, and the IL-2 response test indicated only a low degree of activity.
These results suggest FUT may cause marked eosinophilia via cytokines other than IL-2 or IL-3.
