A patient with severe heart failure was referred to the Marburg University clinic in Germany in 2012. A possible cause was coronary artery disease, but after further examinations, the medical team ruled it out. However, some of the medics working on the case noticed a few notable similarities between the patient’s symptoms and the symptoms of a patient on House, a TV series in which British actor Hugh Laurie plays the lead character, Gregory House, M.D. On the TV show, a patient was experiencing strikingly similar symptoms and was diagnosed as having cobalt poisoning, which was caused by the debris shed by a metal hip replacement.
When the medical team looked into the real-life patient’s medical history, they found that in November of 2010, he’d received a metal hip replacement. Only six months later, the patient began experiencing hypothyroidism, oesophagitis, a mysterious fever, worsening of hearing and vision, and severe heart failure.
Soon after, the patient had the metal hip replaced with a ceramic one. Immediately, his heart function improved, his mysterious fever disappeared, and he was free from the torturous acid reflux.
“Cobalt intoxication has been a well-known cause of cardiomyopathy for over 50 years, but primarily in the context of steel workers exposed to the metal industrially, or in cases of food or drink contaminated by cobalt,” says Dr Juergen R. Schaefer, lead author of the patient’s case report and director of the Center for Undiagnosed Diseases in Marburg.
“Numerous studies have investigated metal exposure due to hip replacements, but in certain situations – where the placement has gone wrong, where there are technical problems with the prosthesis, and strikingly often after an off-label replacement of broken ceramic hips by metal parts – patients are at risk of cobalt poisoning due to hip prosthesis, a problem which appears to be on the increase, and which can be life-threatening.”
Cobalt is one of the metals that is released in to a patient’s system after metal debris has shed from a metal-on-metal hip implant. Smith & Nephew, Wright Medical, and DePuy Orthopaedics, a subsidiary of Johnson & Johnson have been swamped with lawsuits for injuries related to the failure of these metal-on-metal hip designs.