A patient's mysterious symptoms are correctly identified thanks to the US television series
While the information content of the television program generally leaves much to be desired, the television series “Dr. House ”has now been proven to be a life-saving source of information. A doctor correctly recognized the mysterious symptoms of a 55-year-old patient as they were seen in an episode of the US television series. Professor Dr. Jürgen R. Schäfer from the Philipps University of Marburg and colleagues reported in the renowned trade magazine "The Lancet".
The patient was admitted to the Center for Undetected Diseases at the University Hospital in Gießen and Marburg in May 2012 with a number of unexplained symptoms. He showed heart weakness, was almost deaf and almost blind, had a fever of unknown cause, hypothyroidism (hypothyroidism) and reflux esophagitis (esophageal inflammation caused by gastric acid reflux). In addition, the patient suffered from lymph node swelling, especially in the left hip area, the doctors write. "The search for the cause of this combination of symptoms brought us to an episode of the TV series Dr. House that we use for teaching with medical students, ”reports Dr. Shepherd and colleagues. Cobalt poisoning was suspected as the most likely reason for the complaint.
The patient's medical history was "largely uneventful, apart from the fact that both hips were replaced with prostheses," the physician said. In 2010, a broken prosthesis that had been implanted in 2001 was replaced with a new implant on the left hip replaced. The doctors suspected a connection here with the patient's complaints, which appeared two years later, since they knew a comparable case from the TV series. They then used a radiography of the hip to determine that the new prosthesis showed metal wear on the left hip. "The measurement of cobalt and chromium in the blood showed strong increases in these metals," write Prof. The cobalt concentration in the blood sample had reached 15,000 nanomoles per liter (nmol / l), with the normal values being below 15.3 nanomoles per liter. The chromium concentration found was 942 nanomoles per liter (maximum 9.6 nmol / L are the normal value).
The patient's condition quickly stabilized After the cobalt poisoning caused by metal abrasion was identified as the cause of the complaints, the metal prosthesis was immediately replaced by a new ceramic hip prosthesis and the patient also received a so-called cardioverter defibrillator (implant similar to a pacemaker), to compensate for severe heart failure. Shortly after the new prosthesis was implanted, the cobalt and chromium concentrations in the patient's blood plasma already dropped, his condition stabilized and he recovered quickly, with a cobalt concentration of 1,460 nanomoles per in July 2013, fourteen months after the procedure Liters have been measured (chromium 365 nmol / L). The heart function had improved significantly and there were no new febrile episodes or signs of esophagitis. However, the patient's hearing and eyesight hardly recovered. Nevertheless, the case shows that “Dr. House ”can save lives not only on TV but also in reality. (fp)
Image: Kristin Dos Santos, Wikipedia