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Clinical Reviews in Allergy & Immunology

Erschienen in:

15.06.2021 | Review Article

Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?

verfasst von: Anastasios Apostolos, Maria Drakopoulou, Stamatios Gregoriou, Andreas Synetos, George Trantalis, Georgios Tsivgoulis, Spyridon Deftereos, Konstantinos Tsioufis, Konstantinos Toutouzas

Erschienen in: Clinical Reviews in Allergy & Immunology | Ausgabe 3/2022

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Abstract

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.

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Titel: Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?
verfasst von: Anastasios Apostolos
Maria Drakopoulou
Stamatios Gregoriou
Andreas Synetos
George Trantalis
Georgios Tsivgoulis
Spyridon Deftereos
Konstantinos Tsioufis
Konstantinos Toutouzas
Publikationsdatum: 15.06.2021
Verlag: Springer US
Erschienen in: Clinical Reviews in Allergy & Immunology / Ausgabe 3/2022
Print ISSN: 1080-0549
Elektronische ISSN: 1559-0267
DOI: https://doi.org/10.1007/s12016-021-08867-0

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Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire?

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