Reactions 716 - 29 Aug 1998

SNafamostat

Anaphylactoid reaction: case reportA 28-year-old woman developed an anaphylactoid reaction

to nafamostat.The woman had been undergoing haemodialysis for 14

years using heparin as an anticoagulant. However, afterundergoing a parathyroidectomy, nafamostat 30 mg/hour wasused instead of heparin during haemodialysis. Immediatelyafter the start of haemodialysis, she developed chestoppression, abdominal pain, hypotension, tachycardia and apruritic skin eruption. Haemodialysis was stopped and hersymptoms responded to treatment with saline, dopamine andhydrocortisone.

Before the woman’s next haemodialysis session, a skin testwas performed with 50µL of SC nafamostat 10 mg/ml and apositive reaction was seen. However, a drug lymphocytestimulation test for nafamostat was negative. She did notexperience any complications in subsequent haemodialysissessions using dalteparin sodium.

Author comment: ‘We believe the skin reaction test fornafamostat mesilate is a clinically useful test for detection ofallergy to nafamostat mesilate. We suggest that it is performedroutinely, especially in critically ill patients prior to renalreplacement therapy.’Okada H, et al. Positive skin reaction test in haemodialysis patients allergic tonafamostat mesilate. Nephrology Dialysis Transplantation 13: 2166-2167, Aug1998 - Japan 800698833

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Reactions 29 Aug 1998 No. 7160114-9954/10/0716-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved