The many faces of nickel allergy

Darlenski, Razvigor; Kazandjieva, Jana; Pramatarov, Kyrill

doi:10.1111/j.1365-4632.2011.05233.x

Cited by 29 publications

(13 citation statements)

References 75 publications

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“…1 Type 316LVM stainless steel is a chromium, nickel, and molybdenum alloy that is commonly used for implantable medical devices but has been hypothesized to release nickel ions in the past. 2 These factors combined with the temporal course of our patient's presentation suggest a hypersensitivity response, although causation is difficult to prove without patch testing a coil sample. Hypersensitivity symptoms of contact dermatitis typically resolve after withdrawal of offending agents.…”

Section: Discussionmentioning

confidence: 96%

Allergic Dermatitis Caused by Endovascular Coiling of Brain Aneurysm

et al. 2016

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PRECÍSNeurological endovascular coils used for aneurysm embolization may be composed of nickel alloys that can cause transient allergic contact reactions. DISCUSSIONA 39-year-old woman with a history of skin irritation to jewelry presented for patch testing because of abnormally enhancing white matter lesions observed on magnetic resonance imaging (MRI) and neurologic symptoms attributed to inflammation secondary to recently placed endovascular coil components (Fig. 1). After embolization of a left supraclinoid carotid ophthalmic artery aneurysm with 4 detachable Stryker (Stryker Corporation, Kalamazoo, MI) endovascular coils, she immediately developed transient numbness and tingling of her left face and a persistent left-sided headache. An MR image was unremarkable at this time. Three months later, additional paresthesias of the right extremities prompted an extensive negative infectious and rheumatologic work-up by neurology, but a lumbar puncture detected 15 oligoclonal bands, suggesting central nervous system inflammation corroborated by newly enhancing MRI white matter lesions. Etiologies such as multiple sclerosis or acute disseminating encephalomyelitis were ruled out based on inconsistent cerebral spinal fluid patterns. Her symptoms completely resolved after 2 weeks of systemic steroid treatment. At the time of her presentation for patch testing 1 year later, her MRI lesions had completely resolved.Patch testing was performed with the Chemotechnique Diagnostics North American 80 Comprehensive Series and Metal series (Chemotechnique MB Diagnostics AB, Vellinge, Sweden).The tests showed positive reactions to nickel (2+ at 96 hours) and sodium tetrachloropalladate (II) hydrate (2+ at 96 hours) (Fig. 2). Further inquiry into the composition of the coils confirmed the presence of stainless steel alloys with nickel components but no palladium. Repeated requests for a sample of the coil to use for patch testing went unanswered.There have been reports of hypersensitivity to nickel-containing dental, orthopedic, and cardiac medical devices presenting with systemic symptoms, but few cases implicate neurological endovascular devices. The coils placed in our patient were partially composed of type 316 low carbon vacuum melt (LVM) stainless steel. Coil packaging warnings include the possibility of developing allergic reactions to 316LVM stainless steel in patients with metal hypersensitivity. 1 Type 316LVM stainless steel is a chromium, nickel, and molybdenum alloy that is commonly used for implantable medical devices but has been hypothesized to release nickel ions in the past. 2 These factors combined with the temporal course of our patient's presentation suggest a hypersensitivity response, although causation is difficult to prove without patch testing a coil sample. Figure 1. Patch testing results at 72 hours showing positive response to palladium and nickel.

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Section: Discussionmentioning

confidence: 96%

Allergic Dermatitis Caused by Endovascular Coiling of Brain Aneurysm

et al. 2016

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“…Nickel is one of the most common allergen causing contact dermatitis [ 19 ]. The prevalence of nickel allergy in the general population is estimated around 10%, and it still remains the most common cause of contact allergy worldwide.…”

Section: Discussionmentioning

confidence: 99%

The role of nickel allergy in hand dermatitis and its impact on handling cupronickel currency coins. A comparative cohort study from Kuwait

Al-Mutairi

Almutawa

2017

pdia

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IntroductionContact with nickel-releasing coins as a cause of hand dermatitis has been debated.AimStudying a hand dermatitis risk from handling Kuwaiti cupronickel coins among nickel-allergic and nickel non-allergic subjects.Material and methodsOne hundred hand dermatitis patients (group I: nickel-allergic) and 100 matched patients (group II: nickel non-allergic) were selected from over 500 hand dermatitis cases seen between September 2014 and September 2015. Nickel released from Kuwaiti cupronickel coins immersed in a standardized artificial sweat solution was measured at 1, 24, 48, 144 and 168 h at room temperature. Subjects in both groups were exposed to nickel releasing coins. The process was repeated after 3 months using nickel coated coins as controls.ResultsNickel released from 20, 50 and 100 fils Kuwaiti cupronickel coins at 1 week was 28.64, 32.76, 35.76 μg/cm2/week, respectively. Ninety-one patients (29 males, 62 females) in group I and 87 patients (38 males, 49 females) in group II completed the study. 47.3% in group I vs. 13.8% in group II developed dermatitis on exposure to nickel releasing coins. Nickel coated coins resulted in dermatitis in 8.8% of group I vs. 5.7% in group II.ConclusionsNickel is released significantly from cupronickel Kuwaiti coins. Handling of coins caused dermatitis more often in patients with nickel-allergy compared to nickel non-allergic patients.

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“…Rubber gloves are ineffi cient for prevention of nickel contact, as metal ions penetrate through them. Polyurethane coating of metal items can be benefi cial in protection from nickel contact, as are barrier creams containing sodium EDTA [ 94 ].…”

Section: The Impact Of Nickel-induced Dermatitismentioning

confidence: 99%

Nickel and Human Health

Zambelli

Ciurli

2013

Metal Ions in Life Sciences

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This review focuses on the impact of nickel on human health. In particular, the dual nature of nickel as an essential as well as toxic element in nature is described, and the main forms of nickel that can come in contact with living systems from natural sources and anthropogenic activities are discussed. Concomitantly, the main routes of nickel uptake and transport in humans are covered, and the potential dangers that nickel exposure can represent for health are described. In particular, the insurgence of nickel-derived allergies, nickel-induced carcinogenesis as well as infectious diseases caused by human pathogens that rely on nickel-based enzymes to colonize the host are reviewed at different levels, from their macroscopic aspects on human health to the molecular mechanisms underlying these points. Finally, the importance of nickel as a beneficial element for human health, especially being essential for microorganisms that colonize the human guts, is examined.

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The many faces of nickel allergy

Cited by 29 publications

References 75 publications

Allergic Dermatitis Caused by Endovascular Coiling of Brain Aneurysm

Allergic Dermatitis Caused by Endovascular Coiling of Brain Aneurysm

The role of nickel allergy in hand dermatitis and its impact on handling cupronickel currency coins. A comparative cohort study from Kuwait

Nickel and Human Health

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