Cardiac arrest caused by nafamostat mesilate.
A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit. Conventional hemodialysis was reinitiated, and nafamostat mesilate was used again because of a small amount of continued bleeding. Ten minutes after hemodialysis, the patient complained of anaphylactic signs and symptoms such as dyspnea, hypotension, and facial swelling. Epinephrine, dexamethasone, and pheniramin were injected under the suspicion of anaphylactic shock, and the patient recovered. Total immunoglobulin E titer was high, and skin prick test revealed weak positivity for nafamostat mesilate. We first report a case of anaphylactic shock caused by nafamostat mesilate in Korea.
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Hyo Shik
HS
Kim
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Kyung Eun
KE
Lee
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Ji Hyun
JH
Oh
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Chan Sung
CS
Jung
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Dughyun
D
Choi
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Yunsuek
Y
Kim
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Jin Seok
JS
Jeon
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Dong Cheol
DC
Han
Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University, Seoul, Korea.
Hyunjin
H
Noh
Anaphylactic shock; Cardiac arrest; Nafamostat mesilate
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