Laboratory confirmed polymethyl-methacrylate (Palacos)-hypersensitivity after cranioplasty.
Polymethyl-methacrylate (PMMA) as part of bone cement is a widely used material in the context of orthopaedic implants and also in cranioplasty. Although PMMA is characterised by excellent biocompatibility with low intrinsic toxicity and inflammatory activation, a minor portion of patients develop allergic reactions. We present the case of a 39-year-old woman with an increasing headache and a corresponding erythema over the parieto-occipital cranioplasty, which was performed 42 days prior using a PMMA compound. A patch test specific for bone cement components confirmed the diagnosis of a PMMA delayed-type hypersensitivity reaction. The prevalence of allergic reactions to bone cement components are known to vary from between 0.6% and 1.6%, however no adequate, pre-interventional diagnostic tool is currently available. Therefore, physicians are required to consider this differential diagnosis even after an extremely delayed onset of symptoms. This case describes the first ever-reported case in the literature of hypersensitivity to bone cement cranioplasty.
Gautschi
Oliver P
OP
Department of Neurosurgery, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9000 St. Gallen, Switzerland. ogautschi@datacomm.ch
Schlett
Christopher L
CL
Fournier
Jean-Yves
JY
Cadosch
Dieter
D
D000328:Adult; D000707:Anaphylaxis / Q000209:etiology; D001843:Bone Cements / Q000009:adverse effects*; D003399:Craniotomy; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis; D007958:Leukocyte Count; D019904:Polymethyl Methacrylate / Q000009:adverse effects*; D019736:Prostheses and Implants
D001843:Bone Cements; D019904:Polymethyl Methacrylate