Severe cobalt intoxication following hip replacement revision: Clinical features and outcome

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PELCLOVÁ Daniela SKLENSKÝ Martin JANÍČEK Pavel LACH Karel

Rok publikování 2012
Druh Článek v odborném periodiku
Časopis / Zdroj CLINICAL TOXICOLOGY
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.3109/15563650.2012.670244
Obor Traumatologie a ortopedie
Klíčová slova Cobalt; Hip prosthesis; Cardiomyopathy; Hypothyreosis; Hearing loss; DMPS; Chromium
Popis 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.

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