腫瘤形成性石灰化(tumoral calcinosis)が透析膜の変更によって消失した維持透析患者の1例

Abstract

We report a case of improved tumoral calcinosis after switching of a dialysis membrane. A 54-year-old female on maintenance dialysis therapy using polymethyl methacrylate (PMMA) membrane was found to have painless masses on the left side of the anterior cervical resion, pubic symphysis, and dorsum pedis in January, 1990. These masses were diagnosed as tumoral calcinosis by X-ray. Interleukin-6 (IL-6), a multifunctional cytokine, is considered to be responsible for acute and chronic complications, such as dialysis disequilibrium syndrome and dialysis amyloidosis observed in patients on hemodialysis. Then, we measured serum IL-6 of this patient to evaluate biocompatibility of the hemodialysis membrane. This patient showed a higher level of serum IL-6 (140 pg/ml) in post-dialysis compared with that in pre-dialysis (90 pg/ml). Therfore, PMMA membrane was thought to be unsuitable for dialysis therapy in this patient. After switching to regenerated cellulose (RC) membrane in September, 1990, serum IL-6 level decreased rapidly (48 pg/ml) in post-dialysis. Tumoral calcinosis observed in the left side of the anterior cervical region, pubic symphysis, and dorsum pedis almost disappeared 15 months later. This case suggests that serum IL-6 is useful for evaluating biocompatibility of the hemodialysis (HD) membrane.