University Hospital of Reims, France
Title: A new challenge: Assessment of metal prothesis intoxication
Frederic J. Deschamps, is Medical doctor (Lille- France University in 1990) He is PhD in Occupational Toxicology for 1993. He was nominated professor of Medicine in 2002. He has improved for the last 20 years the Department of Occupational Diseases of the University Hospital of Reims (Champagne County). He manages for 1995 the Regional Institute of Occupational Health. He belongs to the French National University College of Occupational Researches and Practionners. He has focused his work an occupational infectious diseases and health effects of low doses toxics with long term exposure.
Cobalt intoxication has become more frequent due to the wide use of Metal Cobalt Hip Implants (MCHI). Health risks that are related to chronically elevated blood to cobalt concentration induced by a normal wear and corrosion of the MCHI. Only a few patients have systemic symptoms of poisoning. Toxic blood cobalt concentration may be accompanied by hypothyroidism, polyneuropathy, impairment of cranial nerves and cardiomyopathy. A 60 years old woman underwent total hip prothesis containing cobalt, three years ago. She had no symptoms, but a blood cobalt routine assessment shows an increase of metal level to 3.2 µg/l (population non exposed <0.6 µg/l). Three months later result obtained was 4.64 µg/l. During the next quarter the leved reached to 8.29 µg/l. It is known that cobalt level assessment concerning a population of patients with cobalt MCHI is around 7 µg/l. The treatment could consist of removal of the prothesis to avoid cobalt poisoning, in relationship with deterioration of the metal femoral head by overlooked particles of the head. It seems important to know that the metal particles spread by lymphatic circulation may continue to release ions ever though the source of wear had been removed. Consequently it can be discussed in patients with normal kidney function to add chelation therapy.
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