title: Severe cobalt intoxication following hip replacement revision: clinical features and outcome.
abstract: BACKGROUND
  Cobalt intoxication has become more frequent due to the wide use of metal hip implants.
  
  
  METHODS
  A 56-year-old male patient underwent total hip prosthesis, with a ceramics-on-ceramics implant. Almost 3 years later, it was replaced by metal implant containing cobalt, chromium, and titanium. He developed weight loss, heart, thyroid, and neurological toxicity, with severe hearing loss. He was treated with 2,3-dimercaptopropane-1-sulfonate (DMPS), and cobalt excretion increased. Clinical symptoms apart from deafness gradually resolved.
  
  
  CONCLUSIONS
  We report significant cobalt poisoning from a damaged hip replacement with cobalt containing implant and a slow abrasion of the metal by residual ceramic particles. Chelation therapy resulted in apparent benefit.
authors.affiliation: Toxicological Information Centre, Department of Occupational Medicine, Charles University, Prague and General University Hospital, Czech Republic. daniela.pelclova@lf1.cuni.cz
authors.forename: Daniela
authors.initials: D
authors.lastname: Pelclova
authors.forename: Martin
authors.initials: M
authors.lastname: Sklensky
authors.forename: Pavel
authors.initials: P
authors.lastname: Janicek
authors.forename: Karel
authors.initials: K
authors.lastname: Lach
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002614:Chelating Agents / Q000627:therapeutic use; D003035:Cobalt / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D002614:Chelating Agents; D003035:Cobalt