Daniela Pelclova1, Martin Sklensky, Pavel Janicek, Karel Lach. 1. Toxicological Information Centre, Department of Occupational Medicine, Charles University, Prague and General University Hospital, Czech Republic. daniela.pelclova@lf1.cuni.cz
Abstract
CONTEXT: Cobalt intoxication has become more frequent due to the wide use of metal hip implants. CASE DETAILS: A 56-year-old male patient underwent total hip prosthesis, with a ceramics-on-ceramics implant. Almost 3 years later, it was replaced by metal implant containing cobalt, chromium, and titanium. He developed weight loss, heart, thyroid, and neurological toxicity, with severe hearing loss. He was treated with 2,3-dimercaptopropane-1-sulfonate (DMPS), and cobalt excretion increased. Clinical symptoms apart from deafness gradually resolved. CONCLUSION: We report significant cobalt poisoning from a damaged hip replacement with cobalt containing implant and a slow abrasion of the metal by residual ceramic particles. Chelation therapy resulted in apparent benefit.
CONTEXT: Cobalt intoxication has become more frequent due to the wide use of metal hip implants. CASE DETAILS: A 56-year-old male patient underwent total hip prosthesis, with a ceramics-on-ceramics implant. Almost 3 years later, it was replaced by metal implant containing cobalt, chromium, and titanium. He developed weight loss, heart, thyroid, and neurological toxicity, with severe hearing loss. He was treated with 2,3-dimercaptopropane-1-sulfonate (DMPS), and cobalt excretion increased. Clinical symptoms apart from deafness gradually resolved. CONCLUSION: We report significant cobaltpoisoning from a damaged hip replacement with cobalt containing implant and a slow abrasion of the metal by residual ceramic particles. Chelation therapy resulted in apparent benefit.
Authors: Larry A Allen; Amrut V Ambardekar; Kalpana M Devaraj; Joseph J Maleszewski; Eugene E Wolfel Journal: N Engl J Med Date: 2014-02-06 Impact factor: 91.245
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