SHM Converge Scientific Abstract ePoster Gallery-A Rare Case of Type I Dialyzer Reaction Presenting as a Recurrent Eosinophilia and Dialysis Intolerance

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This case report describes a 56-year-old woman with end-stage renal disease on hemodialysis who had repeated hospitalizations for missed dialysis, volume overload, and suspected infections. She also experienced recurrent nausea, chest and abdominal pain, and pruritus during dialysis, which caused incomplete treatment sessions. Over time, she developed persistent eosinophilia, with a peak absolute eosinophil count of 20 × 10/L, and markedly elevated IgE (2,768 IU/mL).<br /><br />Because her symptoms and imaging findings included multifocal lung opacities, the initial workup focused on infection and autoimmune disease, but no clear cause was found. A retrospective review later showed that her eosinophil spikes occurred in close temporal association with hemodialysis sessions, raising concern for a type I hypersensitivity reaction to the dialyzer.<br /><br />The dialyzer membrane was changed to an F180/Nipro Cellentia dialyzer. After the substitution, the patient was able to tolerate dialysis without adverse symptoms, and her eosinophil count normalized.<br /><br />The report emphasizes that type I dialyzer reactions are rare but important to recognize. They may be overlooked and misattributed to nonadherence or infection, leading to delayed diagnosis, repeated hospitalizations, and worse outcomes. Early identification of dialyzer hypersensitivity and prompt dialyzer replacement can improve dialysis tolerance, reduce morbidity, and prevent further complications.

Asset Subtitle

Rishi Raghavan

Meta Tag

Author List Basim Bashir Khan, Fahmeed Khakwani, Omer Farooq Bangash, Rishi Raghavan

Category Clinical Vignettes

Concept Type I Hypersensitivity

Concept Hemodialysis Dialyzer

Concept Eosinophilia

Concept Dialysis Intolerance

Concept Dialyzer Reaction

Distinguished Non-Finalist

Presenter Organization VCU School of Medicine

Presenting Author Rishi Raghavan

Track Adult

Keywords

end-stage renal disease

hemodialysis

dialyzer hypersensitivity

type I hypersensitivity

eosinophilia

elevated IgE

dialyzer reaction

volume overload

dialyzer membrane replacement

pruritus

Type I Hypersensitivity

Hemodialysis Dialyzer

Eosinophilia

Dialysis Intolerance

Dialyzer Reaction