Presumptive nickel dermatitis from hemodialysis

J. E. Olerud, M. Y. Lee, D. A. Uvelli, G. J. Goble and A. L. Babb

Presumptive cutaneous hypersensitivity to nickel administered intravenously during hemodialysis was observed in a patient with nickel sensitivity. The source of the nickel was a 316 stainless-steel fitting that came in contact with 6N hydrochloride during dialysis. An in vitro experiment was performed to demonstrate the ability of nickel to be dialyzed into blood through a standard hemodialysis system. A plasma nickel level 89% higher than that of the original dialysate was achieved with a single cycle of dialysis. This is consistent with the plasma protein binding of nickel.