Nickel Allergic Reaction post-Transcatheter Atrial Septal Defect Device Closure: A Case Report | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 32, Volume 88, Issue 1, July 2022, Pages 2480-2485 PDF (594.57 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2022.238375 | ||
| Author | ||
| Fatma Aboalsoud Taha* | ||
| Abstract | ||
| Background: Although transcatheter device closure of atrial septal defect (ASD) is a common, safe, and effective interventional cardiac procedure, some adverse effects have been reported including device migration, cardiac erosion, and nickel allergic hypersensitivity reaction. Objective: Here we report on an eleven-year-old boy who experienced a nickel allergic reaction after transcatheter ASD device closure, and we report on how we managed this critical situation. Case Report: Here we report on an eleven-year-old boy who experienced a nickel allergic reaction after transcatheter device closure of a large ostium secundum ASD with a 34-mm Hyperion™ ASD occluder (Comed, Netherlands). Ten days post-procedure, the patient complained of fever, severe allergic reaction; dermatitis, and pruritic rash on his face, arms, trunk, and genital area. Dug allergic reaction and infective endocarditis was excluded. Immediately the patient was managed as a case of device-induced nickel allergic reaction. All manifestations were resolved completely after one week with high doses of dexamethasone and clopidogrel 75 mg orally for 6 months. Subsequent follow-up for 6-month post-procedure showed that the device was properly seated with no recurrence of the nickel allergic symptoms. Conclusions: Nickel allergy and device allergic syndrome must be considered during transcatheter device closure. Despite still controversial, confirmation of a nickel allergy pre-procedure with the patch testing or with the device itself may be useful. Nickel-avoidance strategies using modified devices could be considered a treatment option for patients with nickel allergy. | ||
| Keywords | ||
| Nickel allergy; Nickel allergic reaction; Atrial septal defect; Occluder devices; Transcatheter atrial septal defect device closure | ||
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