Dr House, please report…

By | Health & Wellness
A hip replacment, shown by this state of the art light weight prothesis, was the cause of a House-like case for several German doctors. Credit image Science Museum London, flickr.com

The hit U.S. television series House seemed to have captivated audiences week in and week out over the course of its eight seasons. The broody doctor has seen his fair share of intriguing cases, and a real life patient’s symptoms might have made an interesting episode.

The man entered the Marburg University clinic following a referral, following cardiac arrest, however all the examinations ruled out the most likely cause related to coronary heart. After the best efforts from the medical team at the German-based clinic, and several repeat visits to his previous doctors, a concrete diagnosis was proving to be elusive. An ideal House scenario.

For those who have yet to see the series, House is a hospital drama based on the Vicodin-loving, misanthropic, rebellious, and intelligent Dr. Gregory House. Along with his diagnostics team, he takes interest in the most peculiar cases, with patients often showing the different symptoms. Fifty minutes later, the doctor puts the pieces of the puzzle together and produces a diagnosis which other physicians might have had challenges finding, and the patient walks into the sunset. Queue credits.

The shear number of varying conditions found on the show may mean Prof. Juergen R. Schaefer, director of the Center for Undiagnosed Conditions in Marburg, teaches a medical class to diagnose rare conditions using the television series. When the aforementioned patient entered Marburg University clinic, he began showing several symptoms, including hypothyroidism, which is an under active thyroid gland, oesophagitis, or an inflammation of the oesophagus, and a fever, as well as increasing blindness and decreasing hearing. Even may have been more intriguing was the enlarged lymph nodes on his left hip.

Dubbed the “German Dr. House”, Professor Schaefer realized the patient was showing symptoms similar to ones previously seen on an episode that first aired back in 2011. In the episode, House diagnosed the fictional patient with cobalt challenges due to debris following a prosthetic hip. In order to get a better understanding of the symptoms their patient was showing, Professor Schaefer and his medical team looked back at the medical history, and noticed the man also received a metal hip replacement two years previously.

Professor Schaefer thus tested for cobalt in his blood, which returned positive for both cobalt and chromium. Cobalt is in fact necessary to the body, deemed an essential dietary mineral, and is used as a component in vitamin B12, a compound may be involved in cell energy use as well as DNA synthesis. However, the patient was bowing high levels of this metal. The cobalt most likely originated from a piece of his prosthetic hip which may have broken away, and a radiograph proved this theory. It has long been known that cobalt causes cardiomyopathy, which explained the patient’s symptoms, yet high levels may be rarely found in most people, with those working in the metal industry encountering the condition the most.

Hip replacements often use the metal as a result of its stability; however, they release ions over time. Generally, these ions are excreted from the body after being removed from the blood by the kidneys, yet in some cases, these ions might accumulate within the body. In addition, microscopic fragments may be taken from the prothesis and enter the blood stream.

Professor Schaefer published his case in the journal The Lancet. Once the correct medication was given, the patient’s symptoms began to decrease, with his heart function notably showing an increase of over 40%. The ability of Professor Schaefer to diagnose the patient based on a fictional television show may have saved his patient’s life.

It might seem even without the cane, the motorbike or the poor bedside manner, Professor Schaefer may be every bit the real life Dr. House.

How valuable are medical series for the health care service?

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