Woman's puzzling decline turns out to be cobalt poisoning from hip replacement
摘要
一名56岁女性因多种严重症状入院，包括双脚刺痛麻木并逐渐向上蔓延至双腿，最终无法感知地面、频繁跌倒。随后症状扩展至双手，并出现短期记忆问题、注意力不集中、易怒、食欲不振及心悸等神经症状。医生查阅病史发现，她曾因甲状腺功能减退调整药物剂量，但未引起警觉。此外，她19年前接受过髋关节置换术，该假体开始失效。最终诊断显示，症状由髋关节假体磨损导致的钴中毒引起。
A 56-year-old woman was admitted to a hospital with an array of alarming symptoms that were only getting worse. For eight weeks, she had a painful "pins and needles" feeling that started in both of her feet and then began working its way up her legs. By the time she arrived at the hospital, she was unable to feel her feet on the ground. She frequently stumbled and clutched at walls to stay up. But the tingling numbness was moving into her hands, too. Then came neurological symptoms. She told her doctors about short-term memory problems and difficulty concentrating. She was irritable and had no appetite. She was experiencing heart palpitations, too.
According to a case report this week in the New England Journal of Medicine, her doctors looked through her medical history for clues, finding nothing that immediately stood out. She had high blood pressure, a history of anxiety and depression, and hypothyroidism (an underactive thyroid). They did notice that, although she had managed the thyroid problem for more than a decade at the same dose of medication, she had been switched four weeks earlier to a stronger dose. But the dosage change didn't immediately raise any red flags.
She also had a history of hip problems. Twenty years before, she had a hip replacement that stemmed from an injury she sustained in a car crash ten years before that. While more than 90 percent of hip replacements last at least 30 years, the woman's started failing her after 19.
转载信息
评论 (0)
暂无评论，来留下第一条评论吧