Metallosis-Induced Warm Antibody Auto-Immune Hemolytic Anemia After Bilateral, Large-Diameter Metal-on-Metal Total Hip Arthroplasty With Complete Remission After Revision

IF 1.5 Q3 ORTHOPEDICS Arthroplasty Today Pub Date : 2024-08-03 DOI:10.1016/j.artd.2024.101471
Alexander Frank Heimann MD , Emanuel Gautier MD , Joseph M. Schwab MD , Peter Wahl MD , Moritz Tannast MD , Emmanuel Levrat MD , Ines Raabe MD
{"title":"Metallosis-Induced Warm Antibody Auto-Immune Hemolytic Anemia After Bilateral, Large-Diameter Metal-on-Metal Total Hip Arthroplasty With Complete Remission After Revision","authors":"Alexander Frank Heimann MD ,&nbsp;Emanuel Gautier MD ,&nbsp;Joseph M. Schwab MD ,&nbsp;Peter Wahl MD ,&nbsp;Moritz Tannast MD ,&nbsp;Emmanuel Levrat MD ,&nbsp;Ines Raabe MD","doi":"10.1016/j.artd.2024.101471","DOIUrl":null,"url":null,"abstract":"<div><p>The use of metal-on-metal bearing couples in total hip arthroplasty can lead to an increased release of metal ions, particularly cobalt and chromium over time. This can lead to local and systemic metallosis, which has cytotoxic, genotoxic, and immunotoxic effects and can cause a host of secondary disorders. We describe the case of a 37-year-old female patient that was diagnosed with warm-antibody autoimmune hemolytic anemia (WAIHA) one and a half years after bilateral large-diameter head metal-on-metal total hip arthroplasty. For 11 years, it was refractory to all therapy, including splenectomy and rituximab, requiring long-term oral prednisone for disease control. Ultimately, systemic metallosis and periprosthetic joint infection were diagnosed, requiring explantation of the prostheses. By the sixth week postoperatively, she experienced complete spontaneous remission of her WAIHA. In conclusion, WAIHA can be associated with systemic metallosis in patients with metal-on-metal prosthetic joint replacements. Both hematologists and orthopedic surgeons should be aware of this.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101471"},"PeriodicalIF":1.5000,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001560/pdfft?md5=a4339e8cf860847945fa1050be317c95&pid=1-s2.0-S2352344124001560-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124001560","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

The use of metal-on-metal bearing couples in total hip arthroplasty can lead to an increased release of metal ions, particularly cobalt and chromium over time. This can lead to local and systemic metallosis, which has cytotoxic, genotoxic, and immunotoxic effects and can cause a host of secondary disorders. We describe the case of a 37-year-old female patient that was diagnosed with warm-antibody autoimmune hemolytic anemia (WAIHA) one and a half years after bilateral large-diameter head metal-on-metal total hip arthroplasty. For 11 years, it was refractory to all therapy, including splenectomy and rituximab, requiring long-term oral prednisone for disease control. Ultimately, systemic metallosis and periprosthetic joint infection were diagnosed, requiring explantation of the prostheses. By the sixth week postoperatively, she experienced complete spontaneous remission of her WAIHA. In conclusion, WAIHA can be associated with systemic metallosis in patients with metal-on-metal prosthetic joint replacements. Both hematologists and orthopedic surgeons should be aware of this.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
双侧大直径金属对金属全髋关节置换术后金属病诱发的温抗体自身免疫性溶血性贫血,翻修后完全缓解
在全髋关节置换术中使用金属对金属轴承偶件会导致金属离子的释放增加,尤其是钴和铬的长期释放。这可能导致局部和全身性金属中毒,具有细胞毒性、基因毒性和免疫毒性作用,并可能引起一系列继发性疾病。我们描述了一例 37 岁女性患者的病例,她在双侧大直径头金属对金属全髋关节置换术后一年半被诊断出患有温抗体自身免疫性溶血性贫血(WAIHA)。在长达 11 年的时间里,包括脾切除术和利妥昔单抗在内的所有治疗方法均无效,需要长期口服泼尼松才能控制病情。最终确诊为全身金属化和假体周围关节感染,需要对假体进行拆卸。术后第六周,她的 WAIHA 完全自发缓解。总之,金属假体关节置换术患者的WAIHA可能与全身金属病变有关。血液科医生和骨科医生都应该意识到这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
期刊最新文献
Early Results of a Patient-Specific Total Knee Arthroplasty Implant Cast From a 3D-Printed Mold Evaluation of a Mobile App to Assist Patient Education and Research in Arthroplasty Vancomycin Is Not an Effective Prophylactic Agent Alone and Should Be Combined With Another Agent Are Activity Restrictions Necessary After Total Hip Arthroplasty: A Systematic Review Operatively Managed Transverse or Short Oblique B1 Periprosthetic Fractures Around a Polished Taper-Slip Femoral Stem Are Associated With Reoperation in One Third of Cases: A Retrospective Cohort Study
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1