Abstract：
Post-dialysis fever is commonly reported in patients undergoing hemodialysis (HD). However, it is often challenging to identify the underlying cause owing to the wide variety of potential factors that can lead to fever. In this case, a 66-year-old Japanese man experienced recurrent fever after HD treatment. Initially, antibiotics were prescribed to treat pneumonia, but it was later discovered that the pneumonia was an alveolar hemorrhage caused by cryoglobulinemic vasculitis. It is believed that cryoglobulin was sensitized by cold exposure owing to the dialysate temperature, which resulted in fever being experienced only after HD. Although treatment for vasculitis required prednisolone and rituximab, simple plasma exchange and a dialysate temperature of 37.5 °C dramatically suppressed the occurrence of post-dialysis fever. Cryoglobulinemia should be considered as a potential cause of fever, as it may be a common occurrence in patients undergoing HD and could be overlooked as a possible cause of localized fever following HD treatment.
摘要：
透析后发烧通常在接受血液透析（HD）的患者中报道。然而,由于可能导致发烧的各种潜在因素，确定根本原因通常具有挑战性。在这种情况下,一名66岁的日本男子在接受HD治疗后出现反复发热.最初，开了抗生素来治疗肺炎，但后来发现肺炎是由冷球蛋白性血管炎引起的肺泡出血。人们认为冷球蛋白由于透析液温度而被冷暴露敏化，这导致只有在HD后才出现发烧。虽然血管炎的治疗需要泼尼松龙和利妥昔单抗，简单的血浆交换和37.5°C的透析液温度可显着抑制透析后发烧的发生。冷球蛋白血症应被视为发烧的潜在原因，因为这可能是HD患者的常见病，并且可能被忽略为HD治疗后局部发热的可能原因。
