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Studies from Ludwig-Maximilians University describe new findings in allergies
2009 AUG 4 - (NewsRx.com) -- Current study results from the report, 'Increased metal allergy in patients with failed metal-on-metal hip arthroplasty and peri-implant T-lymphocytic inflammation,' have been published. "In 16 patients with revised metal-on-metal arthroplasty and peri-implant lymphocytic inflammation, we verified the role of metal hypersensitivity by patch testing (PT) and lymphocyte transformation test (LTT). In the 16 patients with lymphocyte dominated periprosthetic inflammation, allergy history was obtained by a questionnaire, specific serum IgE to aeroallergens was measured to assess atopy, PT to standard and metal series was performed and metal sensitivity was further assessed by LTT using blood mononuclear cells," researchers in Munich, Germany report. "Revision surgery was performed because of pain (8/16), osteolysis (4/16), dislocation (3/16) and loosening of the stem (1/16). Histological examination showed perivascular infiltrates of T lymphocytes, high endothelial venules, fibrin exudation and accumulation of macrophages with drop-like inclusions. Five patients had a history of cutaneous metal allergy and atopy was found in 25% of the patients. In 13/16 patients (81%), systemic metal sensitivity was found based on PT and/or LTT. Patch test reactions were seen in 11/16 patients (69%; partly multiple reactions/patient): 7/16 to Cobalt (Co), 7/16 to Chromium (Cr), 4/16 to Nickel (Ni), and one each to Molybdenum (Mo) and Manganese (Mn). Ten of 16 patients (62%) showed enhanced LTT reactivity to metals: 7/16 to Ni, 7/16 to Co, 5/16 to Cr, 5/16 to Mo and 4/16 to Mn. The lymphocyte dominated peri-implant inflammation may well reflect an allergic hyper-reactivity in these patients, given the high rate of concomitantly found metal allergy," wrote P. Thomas and colleagues, Ludwig-Maximilians University. The researchers concluded: "Despite the overall incidence of metal implant allergy being low, allergic reactions should be included as differential diagnosis in failed metal-on-metal arthroplasty." Thomas and colleagues published their study in Allergy (Increased metal allergy in patients with failed metal-on-metal hip arthroplasty and peri-implant T-lymphocytic inflammation. Allergy, 2009;64(8):1157-65). For additional information, contact P. Thomas, Ludwig-Maximilians-University Munich, Dept. of Dermatology and Allergology, Frauenlobstr 9-11, Munich 80337, Germany. Publisher contact information for the journal Allergy is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Germany, Munich, Aeroallergen, Allergies, Allergy Medicine, Arthroplasty, Dislocations, Hypersensitivity, Inflammation, Osteolysis, Surgery. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2009, Life Science Weekly via NewsRx.com.
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