A severe anaphylactoid reaction during Cascade Filtration in a patient receiving ACE inhibitors

Abstract We report a case of severe anaphylactoid reaction in a patient during the first treatment with Cascade Filtration (CF), utilizing a cellulose-diacetate hollow-fiber filter. Similar reactions were not seen in another seven patients with the same medical pathology (Essential Mixed Cryoglobulinemia Type 2 with monoclonal IgM), who also underwent treatment with CF but did not receive ACE inhibitors. The anaphylactoid reaction (IgE independent) could be due to an accumulation of bradykinin caused by blockage of catabolism by ACE inhibitor and by increased and rapid synthesis following contact with inert materials (cellulose diacetate).