Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?
Atrial septal occluders
Nickel allergy
Nickel hypersensitivity
Review
Journal
Clinical reviews in allergy & immunology
ISSN: 1559-0267
Titre abrégé: Clin Rev Allergy Immunol
Pays: United States
ID NLM: 9504368
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
accepted:
31
05
2021
pubmed:
16
6
2021
medline:
3
6
2022
entrez:
15
6
2021
Statut:
ppublish
Résumé
Nickel is one of the most common contact allergens worldwide; it is used as the main component of the devices used for atrial septal defects (ASDs) and patent foramen ovale (PFO) closure. Developing nickel hypersensitivity after PFO/ASD occlusion is significantly rarer described in medical literature than typical nickel contact sensitization. The exact pathophysiological mechanism of this "device syndrome" remains unknown, and many question the real incidence or even the existence of this clinical entity. Nevertheless, it has been associated with a wide spectrum of symptoms, including chest pain, migraines, palpitation, and dyspnea. Skin patch tests are the first-line approach to diagnose nickel hypersensitivity. However, diagnostic criteria for the device syndrome have not been developed, and diagnosis in reported cases is established by a process of elimination. Management-drug therapy (corticosteroids, clopidogrel, etc.) or even surgical explantation in severe cases-of patients developing such clinical manifestations after percutaneous PFO/ASD occlusion is empirical. Undoubtedly, endocardiac device-related nickel hypersensitivity requires more focused research to discover the underlying mechanism as well as to develop reliable prognostic tests for detecting high-risk patients and preventing severe nickel hypersensitivity reactions.
Identifiants
pubmed: 34129170
doi: 10.1007/s12016-021-08867-0
pii: 10.1007/s12016-021-08867-0
doi:
Substances chimiques
Nickel
7OV03QG267
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
476-483Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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