Ethylene oxide sensitivity in hemodialysis patients.
Sera from 138 patients who had experienced hypersensitivity-type reactions while on hemodialysis (reactors) were examined retrospectively by the radioallergosorbent test (RAST) for specific IgE antibody to ethylene oxide (ETO). Seventy-eight hemodialysis patients without a history of reaction were also evaluated as controls. Elevated serum RAST values (greater than 2.0) were more common in reactors (63%) than in controls (11%, p less than 0.001). In a second study, RAST assays were performed using human serum albumin conjugated to ETO (HSA-ETO) as antigen and also using a concentrate of fluid used to rinse ETO-sterilized dialyzers ("dialyzer extract") as antigen. The RAST ratios obtained with HSA-ETO were similar to those obtained using the dialyzer extract (rank order correlation coefficient = 0.829, p less than 0.001). In a third study, RAST inhibition was demonstrated both by HSA-ETO and dialyzer extract. Our results, extending previously published reports, suggest that hypersensitivity to ETO might play an important role in hemodialysis-associated hypersensitivity-type reactions.
D000941:Antigens / Q000276:immunology; D004342:Drug Hypersensitivity / Q000209:etiology*; D005027:Ethylene Oxide / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007688:Kidneys, Artificial / Q000009:adverse effects; D011446:Prospective Studies; D011852:Radioallergosorbent Test; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000276:immunology
D000941:Antigens; D012709:Serum Albumin; D007073:Immunoglobulin E; D005027:Ethylene Oxide