For a year, the patient suffered from a range of worsening symptoms that
left doctors stumped.
His heart started failing, his sight and hearing deteriorated, he suffered
lymph nodes and an inexplicable fever. The
outlook was grim.
Only Dr Gregory House, TV's misfit medical genius, could solve the mystery:
the cause was an eroded prosthetic hip.
But this time the sleuthing did not happen on the small screen but in real
life, The Lancet reported.
meds tied to B12 deficiency
Serious and baffling decline
Thanks to an episode in House, doctors at a German clinic were
able to save a 55-year-old man who was in a serious and baffling decline.
The patient had been referred to Marburg's Centre for Undiagnosed Diseases
in May 2012.
Poring over his medical history, the team found a past that was
uneventful... apart from a double hip
They pounced on this detail. Recalling an episode from the seventh season of House, the team began to suspect cobalt poisoning, probably from a
worn hip implant.
Scans and blood tests confirmed the suspicion and the patient soon had his
metal prosthesis replaced by a ceramic one.
"Shortly after the hip replacement, the patient's plasma (blood) cobalt
and chromium concentrations decreased and the patient stabilised and recovered
slightly," the case report said.
By July last year, 14 months after the operation, his heart function
improved to 40%, the fever was gone and so was the acid reflux. The patient had
by then received a defibrillator to aid his damaged heart.
in public places saves lives
His hearing and vision, unfortunately, recovered only slightly, said the
Not only entertaining
"It was helpful for me that I was aware about the cobalt problems
thanks to Dr House," team leader Juergen Schaefer told AFP, while
stressing that other diagnostic tools were brought into play as well.
"All this demonstrates nicely that well-performed entertainment is not
only able to entertain and educate, but also to save lives."
"House" is the story of a grumpy and cynical diagnostician who
specialises in solving medical mysteries that other doctors cannot crack.
He is based on Sherlock Holmes, whose character was in turn inspired by
real-life 19th century Scottish doctor Joseph Bell who, like House, used
deductive reasoning as a diagnostic tool.
Toxic metals in blood stream
Schaefer said he was a fan of the TV show and had been using episodes from
the series, based on real cases, as part of his lectures for several years now,
"to attract my students' attention for rare or unusual diseases".
He has been dubbed the "German Dr House" by colleagues, students
and the media.
Schaefer said his centre has treated at least five other patients with
cobalt poisoning, though with less severe symptoms.
"There must be more awareness to the potential side effects of metal
implants in humans," he said.
The case report added that cobalt poisoning in hip replacement patients was
"an increasingly recognised and life-threatening problem".
Erosion of a replacement hip, often the result of a botched operation or
dodgy prosthesis, can release toxic metals into the blood stream.
Cases of heart failure as a result of cobalt poisoning are rare and have in
the past mainly been observed in steel workers and heavy consumers of a
specific Quebec beer that was found in the 1960s to have had cobalt sulphate
added for foam stability.
failure hits the poor extra hard
failure successes not seen in younger patients