A case of titanium-coated pacemaker allergy in a 14-year-old patient
- Authors: Esakova N.V.1, Termosesov S.A.1, Shkolnikova M.A.1, Pampura A.N.1
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Affiliations:
- Veltischev Research and Clinical Institute for Pediatrics of the Russian National Research Medical University named after N.I. Pirogov
- Issue: Vol 19, No 3 (2022)
- Pages: 404-409
- Section: Case reports
- URL: https://rusalljournal.ru/raj/article/view/1567
- DOI: https://doi.org/10.36691/RJA1567
- ID: 1567
Cite item
Abstract
Currently, titanium is widely used in implants, particularly in cardioresynchronizing devices, such as pacemakers, because it is well tolerated by patients and rarely causes allergic reactions. The low informative value of the allergy testing for titanium makes its allergy diagnosis difficult. Experts reported that false negative results of skin application tests with titanium may be associated with the use of titanium tetrachloride in allergy testing, which is not pure metal. The use of glucocorticoids in treating pacemaker component-related allergy is temporary and does not exclude recurrence of inflammation. The main treatment for patients is the replacement of the implantable system with a device made of the most hypoallergenic materials.
The present paper describes a case of a 14-year-old patient with an allergy to a titanium-coated pacemaker. This is the first time eosinophil cationic protein and tryptase are detected at the inflammation site while diagnosing allergy to a titanium-coated pacemaker. This study concludes that the level of eosinophilic cationic protein and tryptase in the inflammation site is a promising marker in metal allergy diagnosis and requires further research.
Timely diagnosis of titanium allergy and the reimplantation of a gold-coated pacemaker prevent the recurrence of inflammatory changes in the area of pacemaker insertion and infectious complications, thereby significantly improving patient prognosis.
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About the authors
Natalia V. Esakova
Veltischev Research and Clinical Institute for Pediatrics of the Russian National Research Medical University named after N.I. Pirogov
Author for correspondence.
Email: env007@rambler.ru
ORCID iD: 0000-0001-8792-2670
SPIN-code: 6924-9726
MD, Cand. Sci. (Med.), Senior Research Associate
Russian Federation, MoscowSergey A. Termosesov
Veltischev Research and Clinical Institute for Pediatrics of the Russian National Research Medical University named after N.I. Pirogov
Email: stermosesov@pedklin.ru
ORCID iD: 0000-0003-2466-7865
SPIN-code: 5785-5776
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowMaria A. Shkolnikova
Veltischev Research and Clinical Institute for Pediatrics of the Russian National Research Medical University named after N.I. Pirogov
Email: m_shkolnikova@pedklin.ru
ORCID iD: 0000-0001-7115-0186
SPIN-code: 9051-7107
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowAlexander N. Pampura
Veltischev Research and Clinical Institute for Pediatrics of the Russian National Research Medical University named after N.I. Pirogov
Email: apampura@pedklin.ru
ORCID iD: 0000-0001-5039-8473
SPIN-code: 9722-7961
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowReferences
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