Abstract
Recently, in the hemorrhagic tendency and pre- and post- operative status, nafamostat mesilate has often been used as an anticoagulatiant drug during extracorporeal circulation, and reports of anaphylaxis induced by nafamostat mesilate have accumulated. We have observed five cases of anaphylaxis which were induced by the injection of nafamostat mesilate in patients undergoing maintenance of hemodialysis during the past sixteen months. These patients had a history of nafamostat mesilate administration, but had never experienced allergic reactions. Within 30 minutes after initiation of hemodialysis, all 5 cases developed anaphylaxis. Severe hypotension appeared in three cases. The result of a lymphocyte stimulation test (DLST) using nafamostat mesilate was positive in the three of four cases, although antibody of anti-nafamostat mesilate IgE was negative in all cases. There were no other factors present that might have induced dyspnea and hypotension. Therefore, it might be surmised that this event was induced by nafamostat mesilate. It is difficult to anticipate the occurrence of anaphylaxis, but should be considered when the possibility of anaphylaxis nafamostat mesilate is used.
