title: Hypersensitivity reactions during haemodialysis: the choice of methods and assays.
abstract: Our considerations about assays to assess agents and mechanisms involved in hypersensitivity reactions can be summarized as follows. The measurement of total IgE is recommended since it confirms a history of atopy of the patient and is a quick and inexpensive laboratory assay. If, based on the anamnesis, a particular allergen can be suspected to be involved in the clinical reaction a RAST against this compound is highly recommended. In any case of a severe clinical reaction the RAST against ethylene oxide is mandatory to confirm or exclude the involvement of ethylene oxide. The radioallergosorbent test (RAST) should not be used as a screening test for an entirely unknown allergen. The determination of histamine in plasma samples can be applied for specific scientific questions but cannot be recommended as a routine test with first priority. In contrast, the measurement of bradykinin should be established as soon as possible as a routine test for all new materials which are developed for application in the extracorporeal circuit. An initiative of the haemodialysis community is recommended to assure the commercial availability of a reliable bradykinin immunoassay.
authors.affiliation: Akzo Research Laboratories Obernburg, Department Arlo-CDB, Germany.
authors.forename: H D
authors.initials: HD
authors.lastname: Lemke
mesh_terms: D000706:Anaphylatoxins / Q000378:metabolism; D001920:Bradykinin / Q000097:blood; D006636:Histamine Release; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology*; D007159:Immunologic Tests; D008954:Models, Biological; D011852:Radioallergosorbent Test; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D000706:Anaphylatoxins; D001920:Bradykinin