Antibodies to Toluene Düsocyanate in Patients with and without Dialysis Anaphylaxis

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Abstract
In a majority of patients with anaphylaxis to dialysis, ethylene oxide has been identified as an etiologic agent. In a significant minority of patients sustaining such reactions, the antigen remains unidentified. Conflicting results have been published with regard to isocyanates as a possible antigen. The authors studied 19 hemodialysis patients with anaphylaxis in whom IgE against ethylene oxide–human serum albumin (ETO–HSA) was not identified (Group 1) and 25 peritoneal dialysis patients without anaphylaxis (Group 2). IgE against toluene diisocyanatehuman serum albumin (TDI–HSA) was found in one patient in Group 1, and a similar incidence of IgG against TDI–HSA in Group I (16%) and Group 2 (12%) was noted. The results do not suggest that IgE against TDIHSA is an important cause of dialysis anaphylaxis.