Type I hypersensitivity reaction may manifest as anaphylaxis causing urticarial plaques or papules on the skin [3]. Proprietary process produces the highest quality allograft tissues. See an allergist (MD who specializes and has residency training in this discipline) and let them test you, probably with a skin patch or some variant. J Biomed Mater Res 2000: 53: 480489. This makes it an adequate metal of choice for intraosseous use in medical procedures. 18, no. Oral Care Center articles are reviewed by an oral health medical professional. This requires immediate attention and an X-ray for further investigation. It is used worldwide by healthcare professionals to help determine whether patients are Careers. They are real and they manifest themselves over time. However, all the symptoms were resolved after the removal of the offending agent [57]. doi: 10.1016/j.apsusc.2013.12.029. aseptic osteolysis. a. viable lymphocytes are required therefore logistical issues of shipping often complicate testing; But autoimmunedeficiency raised as well as the number of prothetic treatments and envireonmental influence and stress. ii. 1. The blood test does not do well as it's "pure" they test for and it only reacts when the item in question IS already in you. Suspecting systemic contact dermatitis to metal buttons and I have been asked to evaluate. The patient also started having low-grade fever, nausea, vomiting, joint pain, diffuse rash, and fatigue. The lymphocyte transformation test has several issues: The patient has allergic symptoms reported from IV contrast, nickel, titanium, iodine, metoclopramide, and oxalate. Goolge Titanium allergy test and I'm sure you will find it. In the following years, the patient went through an ERCP procedure multiple times due to her sphincter of Oddi dysfunction followed by laparoscopic rectopexy for a rectal prolapse. 1. If medical or dental professionals suspect that you might be allergic to the titanium in your dental implant, the first step is to take diagnostic tests, such as a patch test. Pigtail plastic stents are used to remove the intra-abdominal drainage during procedures such as endoscopic retrograde cholangiopancreatography (ERCP) [8]. of weight loss in only four months of duration. All but one clip was removed and the patient reported resolution of most symptoms within one week of surgery. The results showed that Jeske was allergic to nickel; the screws in his feet contained 14-16% nickel. Immediately after removal of his last palladium containing white gold crown all of his paralysis resolved.At the November 2019 meeting of the FDA's Committee Investigating Metals Used in Medical Devices, Dr. Schroeder presented Jeske's case and the cases of some of his other patients. Some things are not clear cut. d. most literature continue to recommend patch testing as the standard, possibly with the exception of titanium due to potential occurrence of false negative patch skin test results. Orthopedic Analysis Eleven months prior, the patient had undergone cholecystectomy due to acute cholecystitis complicated by a liver abscess. In a pilot study, 20 patients also underwent both patch testing and a lymphocyte transformation test (LTT-MELISA) for the same metals. Jurczak P., Witkowska J., Rodziewicz-Motowido S., Lach S. Proteins, peptides and peptidomimetics as active agents in implant surface functionalization. A quote from Fishers textbook on contact dermatitis is the following: if metal salts were tested close to each other a strong positive to nickel would be accompanied by false positive patch test reactions to adjacent metal salts, particularly cobalt and copper (2). This will improve the patients quality of life and prevent serious complications. Lymphocyte proliferation, using Lymphocyte Transformation Testing (LTT), and cytokine release provided quantitative reactivity measurement, where a stimulation index of >2 indicated metal sensitivity. Ask The Expert Archive Main Page Some symptoms include chronic dermatitis and other reactions depending on the specific organ involved [10]. Six metal surgical clips removed from the RUQ via fluoroscopic guidance. Advice for Straumann Bone Level Implants in posterior mandible? "Titanium: a review on exposure, release, penetration, allergy, epidemiology, and clinical reactivity." Tsh Normal All bld normal carol. See this image and copyright information in PMC. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Another incredible case report of a woman with 18 surgical clips in her neck. M. Little, P. C. Munipalle, and O. Nugud, A rare late complication of laparoscopic cholecystectomy, Case Reports, vol. Materials Science and Engineering: C. 2016;59:624635. In most irritant reactions, intensity usually wanes between the time of patch removal and the final reading. My B12 was normal. Neuro Endocrinol Lett. M. Tu and Y. Wu, Multiple allergies to metal alloys, Dermatologica Sinica, vol. The researchers forecast that by 2030, more than 11, 000 people a day will have implant surgeries in the U.S. alone. Other case reports by Shi et al., Tawil et al., and Towers et al., mentioned hypersensitivity reactions due to titanium in different surgical procedures such as anterior cervical discectomy, dental implants, and spinal fixation devices. The titanium in the implants fuses with the jawbone, ensuring that the implant wont slip or make noise. We describe a case of chronic abdominal pain, which is potentially complicated by retained titanium surgical clips and subsequently a retained portion of a pigtail catheter. I have attached some archived Ask the Expert questions about metal allergy. It is used worldwide by healthcare professionals to help determine whether patients are hypersensitive to metals commonly used in dental restorations or medical implants. Correction on the last thread last word should read capsules, not injections. doi: 10.1016/j.msec.2015.10.063. This site uses cookies. The management of any metal allergy including titanium involves removing specific offending agents and avoiding potential triggers to hypersensitivity reactions. ", I had transplants in September 2009 December 16th 2009 very sick and have never been allergic to anything and now 5th time to almost die and surgeon contacted today 25th Jan 2010 going tomorrow morning I have not been in pain other than swelling tongue not breathing and and almost dead We will see wish me luck. Regardless of all these factors, surgeons and clinicians must have a high clinical suspicion of RFB and appropriate diagnostic imaging for diagnosis and removal of the RFB. In the study, 35 patients with failed orthopedic implants and 15 patients scheduled for orthopedic implant surgery were tested for metal hypersensitivity using the MELISA test. Concentrations of 2023 American Academy of Allergy, Asthma & Immunology. Validity of MELISA for metal sensitivity testing. Since then, has had persistent systemic pruritic papular rash - worse in scalp and hairline. Recently, cases of titanium hypersensitivity have also been described. This resulted in approximately 75lbs. Especially those based on called "nano"-Ti-particles Of 31/100 patients with an apparent history of nickel sensitivity determined during preoperative assessment of subjects, 12 tested negative on both tests, and 4 with a negative history of nickel sensitivity tested positive. Antifungal activity of Ag:hydroxyapatite thin films synthesized by pulsed laser deposition on Ti and Ti modified by TiO2 nanotubes substrates. This information is for educational purposes only. Faster and more secure then Zirkonia implants. Review our cookies information for more details. Exposition doesn`t come over night- but gradualy. Mediators of Inflammation. Therapy resistant dermatitis In the past decade Dr Schroeder has removed over 1,000 implants in over 400 patients. Have you seen a rheumatologist? It's called Melisa. If you have any questions, call the Drug Allergy Clinic at (615) 936-2727, 8 a.m.-4:30 p.m. Monday through Thursday or 8 The MELISA test has been known to be a more sensitive test to metal allergy but lacks specificity in the proliferation of lymphocytes [3]. Effect of blood component coatings of enosseal implants on proliferation and synthetic activity of human osteoblasts and cytokine production of peripheral blood mononuclear cells. T. Okamura, M. Morimoto, D. Fukushima, and G. Yamane, A skin patch test for the diagnosis of titanium allergy, Journal of Dental Research, vol. This has been confirmed by my health care giver. Titanium is another type of metal that is utilized extensively in cardiac pacemakers, dental procedures, arthroplasty, body piercing, and spectacle frames [2]. From these patients, a final group of 42 patients agreed to participate in the study, 35 of which were female and 7 were male. The results were correlated with clinical and anamnestic data. reports an 86-year-old woman who presented three years to postlaparoscopic cholecystectomy with subdiaphragmatic abscess due to titanium surgical clips used during the procedure [4]. The patients social history is insignificant, with no smoking or alcohol consumption. Toxics. However, in October 2020, the patient started having new symptoms of watery, nonbloody diarrhea associated with her chronic RLQ pain. Fishers textbook on contact dermatitis provides a summary of the state of the art for in vitro lymphocyte proliferation (2): The site is secure. The one we elected is from a German/Swiss based company called Z-Systems. A case by Little et al. WebMELISA is a blood test to aid the diagnosis of metal hypersensitivity. The follow-up 6, p. 630, 2014. Safe for patients with metal allergies Zirconia implants are a viable option for patients who have an allergy to titanium or adhere to holistic dental principles. The CT scan showing a portion of the pigtail catheter lodged within the cecum in a coronal view (a), sagittal view (b), and axial view (c). Major A decision was made to remove all the metal surgical clips laparoscopically via fluoroscopic guidance (Figure 1). Very small amounts of various The patient initially presented to the clinic with an intermittent right upper quadrant (RUQ) pain in 2016. Failure of the implant and delayed or poor wound or surgical site healing hav occurred; Our case is about a 28-year-old female presenting with a spectrum of abdominal symptoms with a complicated medical history. The MELISA Medica Foundation, which conducts the MELISA test for metal sensitivities, estimates that as many as 4% of the population could be allergic to titanium. Sincerely, She reported extensive health issues such as skin rash, hair loss, memory loss, difficulty concentrating, severe shortness of breath, hot and cold flashes, metallic taste in the mouth, abdominal bloating, joint and body aches, muscle pain and tightness, insomnia and more. Filipoiu DC, Bungau SG, Endres L, Negru PA, Bungau AF, Pasca B, Radu AF, Tarce AG, Bogdan MA, Behl T, Nechifor AC, Hassan SSU, Tit DM. After the diagnosis of RFB, the preferred approach is to remove the RFB laparoscopically [13]. I have copied the question and our response below. Evaluation of symptoms suspected to be dependent on immunologic responses to implanted metals is complicated by the limitations of testing. How did you come to get tested for a titanium allergy (did you have previous joint surgery?) The .gov means its official. Fage, Simon W., et al. It is available from laboratories in this country. There is no need to take the MELISA test prior to surgery. An implant is a great replacement because it looks and feels like a real tooth. Finally, the blood test could be effectively used to diagnose type IV hypersensitivity allergic reactions, including contact dermatitis or eczema reported by few studies on titanium allergy [12]. Some times I burning all over & my tongue burns. Within a few days, she started having vomiting, bloating, weakness, fatigue, and intense RLQ abdominal pain. v. Postoperative testing may help in determining if metal allergy is responsible; Preoperative testing may identify preexisting sensitivity but does not predict likelihood of joint failure and may help with selection of type of implant; This is of course important in dealing with metal implants. Showed many positives at 72 and 96 hours including 14 metals and methacrylate glue. 6. de Graaf, Niels PJ, et al. I also think this form of dentistry s/b considered and covered as MEDICAL. A pigtail catheter is a universal drain used to remove fluids or abscesses from organs, ducts, or body cavities. 2014;293:3745. Toxicology in vitro 8.5 (1994): 991-1000. Neuroendocrin Letters 2006;27:17-24. Pure Titanium is very reactive and might get binded to organic substrate which then promotes the allergic answer. Question posted to Ask the Expert website 4/25/2012: The International Journal of Implant Dentistry notes that due to implants' corrosion and wear, titanium alloy particles can get deposited in the surrounding tissues. The decision forward would be based upon this discussion. LTT-MELISA is touted as superior to other testing modalities, such as patch testing, particularly for titanium, possibly due to the reduced immunologic reactivity of titanium (4,5). 8600 Rockville Pike Making this recommendation on a test that is not generally accepted is difficult, but you may wish to document a shared decision making discussion regarding this controversy. The MELISA test may be used in two ways for orthopaedic patients. This study is aimed at proving the clinical benefit of the MELISA test in the minimization or complete elimination of health problems in patients with confirmed Transpiration sweat is very aggressive and can induce allergic response to materials we never had problem with. In many ways, implants function like natural teeth. Medical content developed and reviewed by the leading experts in allergy, asthma and immunology. Then the titanium-alluminium-vanadium alloy gets exposed. 1. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Contact-dermatitis-2015.pdf The MELISA test was validated in 2003 by Valentine-Thon and Schiwara. The skin patch test has not yet been developed as the valid standardized test for titanium allergy. 3, no. This causes type IV hypersensitivity reaction through sensitization of T lymphocytes and macrophages. MELISA Foundation, etc. Concerned this may give false negative results with patch testing. The prevalence of metal hypersensitivity in patients with implants is significantly higher than in the general population, with an even higher rate among patients with failed or failing implanted devices. Okamura et al. If metal allergy is consistent- (beware false positive results) remove all metall in mouth. The commercially licensed, in vitro lymphocyte transformation test for detecting sensitivity to metals (LTT-MELISA) is not FDA approved and generally is not covered by insurance (1,2). After removal of the titanium material, fracture healing was achieved and the eczema cleared. On the contrary, IFN-gamma, IL-2, IL-4, IL-10, and IL-12 production to the ELISpot, patch test results, sensitization against other metals, and atopy score did not significantly discriminate between sensitization with and without allergy. I emphasize that this testing is not FDA approved. Dana Jeske, a mechanical engineer living near Seattle, experienced intermittent paralysis for five years, before regaining his ability to walk and move his b "Metal hypersensitivity testing should be offered to patients before surgery to minimize the risk of implant failure", concluded this study from Charles University, Prague; "especially those with autoimmune diseases, asthma, and/or allergies." WebTitanium is a reactive metal with a including titanium may mediate metal hypersen- titanium allergy, titanium release without any native oxide film thickness of about 4 Morphology consistent with acute eczema apr18 1, article bcr2013009070, 2013. The dr confirms thru xray that it is in properly. Arakelyan M, Spagnuolo G, Iaculli F, Dikopova N, Antoshin A, Timashev P, Turkina A. Fonacier L, Bernstein D, Pacheco K et al. 2/12/2021 In summary, the lymphocyte transformation test itself is a validated test for delayed hypersensitivity. The surgical pathology report for the removed catheter specified foreign body consisting of synthetic stent measuring 10.0cm in length and 0.3cm in diameter (Figure 4). Dear Richard Hughes, DDS,FAAID, FAAIP.DABOI 2022 Nov 23;10(12):716. doi: 10.3390/toxics10120716. All Rights Reserved. The patient was referred to an infectious disease specialist and kept on a course of oral vancomycin and fidaxomicin. I live with constant pain and stiffness that changes by the minute and radiates through my pelvis and legs. I would share this information with the patient and the orthopedist and recommend a titanium implant without nickel unless the repeat tests do not show sensitivity. In our case, the patients nonspecific symptoms due to the titanium clips were quite different from the symptoms reported in other studies and may not wholly be attributable to titanium hypersensitivity since the patient had known allergic reactions to various other allergens as well. Titanium alloy (TiAl6V4): titanium, vanadium, aluminium, traces of nickel. You may be dealing with angry back syndrome from the start. Lindemann M, Rietschel F, Zabel M, Grosse-Wilde H. -, Catauro M., Bollino F., Papale F. Preparation, characterization, and biological properties of organic-inorganic nanocomposite coatings on titanium substrates prepared by sol-gel. The body does not uptake B 12 via tablets or injections. I think that there is credible evidence in the literature to indicate that delayed hypersensitivity testing to metals can be a useful test in detecting the presence of contact allergy. Contact Dermatitis. 4. Hypersensitivity reactions to metallic implantsdiagnostic algorithm and suggested patch test series for clinical use. Carol: This sounds more like a vitamin B 12 deficiency, but see what your Drs. Clipboard, Search History, and several other advanced features are temporarily unavailable. MELISA is a blood test to aid the diagnosis of metal hypersensitivity. Source In the case of implants, the few people that report having them removed also report immediate improvement. Dental implants are typically made from titanium metal alloys, and in some rare cases, people may experience titanium allergy symptoms. 62, no. Background: Sensitization to orthopaedic implant materials is an unpredictable event that might affect implant performance. Upon removal the pain disappeared. 145162, 2008. Applied Surface Science. If LTT-MELISA testing is to be considered, test kits, locations of laboratories offering this test and other information is available at FAQs for US Customers - MELISA. I emphasize that this testing is not FDA approved. I have attached some archived Ask the Expert questions about metal allergy. Therefore a more inert Ti-alloy might be even more secure, as it interacts not that fast with the tissue. ii. It is a very real reaction that needs to be dealt with. These reactions are T cell dependent and patch testing would be the preferred method if we had reagents for each metal and if all of the metals penetrated the epithelium equally. Have new referral 62 year-old female smoker with focal seizure in 2017 - evaluation showed brain tumor confirmed to be malignant with primary in lung. This test is also available in the US. WebMELISA is a scientifically proven and clinically validated blood test that detects type-IV hypersensitivity to multiple metals at the same time. WebTitanium implants - testing for allergy MELISA TESTING IN DENTISTRY 1 OF 2 Titanium has traditionally been seen as a biocompatible metal which osseointegrates Abstract I had bone tumor & metal rods placed in my femor a 1 yr & 6 months ago .. Referred to me to patch testing. I strongly recommend zircon implants. Minor 2022 Nov 4;8(1):51. doi: 10.1186/s40729-022-00451-1. Carol: keep an eye on the situation and as you already have consult with your physician. Metal allergies and MELISA testing were featured in the podcast Jump in Detox! created by Nicolas Mayaud N.D., a heavy metal detox expert in Switzerland. "A possible metal allergy could be considered when a patient presents with nonspecific, possibly life-threatening complications, as seen with the patient in this case report." Traces of nickel (0.03%) may be found even in commercially pure titanium due to the production process. "Metal allergy and systemic contact dermatitis: an overview." RFB should be included in the differential diagnoses when the patient presents with acute reactions after surgical procedures. It is important to diagnose RFB promptly and remove it as soon as possible due to life-threatening complications such as gastrointestinal bleeding, intestinal obstruction, and perforation [13]. Results: Sensitized individuals with an allergy displayed significantly higher lymphocyte transformation test (LTT) responses than sensitized volunteers without allergy and controls (P<0.05 and P<0.01, respectively). 26 Its usefulness may be improved if patients are tested with chemicals relevant to their problem. It also sheds light on retained foreign bodies as a possible cause of abdominal pain in patients who have gone through various surgical procedures in the past. They work even in a periodontic compromised oral situations. Another helpful test is called the Memory Lymphocyte Immunostimulation Assay, or MELISA test. Neuroendocrinology Letters 2003; 24(1/2):57-64, Copyright 2022 MELISA Diagnostics Limited. These HA-implants heel quite well and also fast. The pain was sharp and stabbing in nature and radiated from the umbilicus, and the patient rated the pain 10/10 on a scale, causing her significant discomfort. 2020;276, article 102083 doi: 10.1016/j.cis.2019.102083. Thank you again for your inquiry and we hope this response is helpful to you. iii. Usually retained foreign bodies are found after complaints such as pain, infections and a palpable mass. 5, no. All rights reserved. However, IFN-gamma responses towards chromium chloride were significantly correlated with the strength of patch test reactivity (r=0.49, P=0.002). Other materials are recent or less proven. The easiest and most affordable way to clinically deliver bone graft for socket preservation. She reported extensive health issues such as skin rash, hair loss, memory loss, difficulty concentrating, severe shortness of breath, hot and cold flashes, metallic taste in the mouth, abdominal bloating, joint and body aches, muscle pain and tightness, insomnia and more. However, the skin-patch test is still not the best diagnostic modality due to failure in positive reaction to most titanium allergy cases [3]. Chapter 8, Medical devices, implants and equipment. Unable to load your collection due to an error, Unable to load your delegates due to an error. Would lymphocyte transformation testing help me determine more accurate picture of his metal contact allergy and help orthopod choose appropriate joint for revision? THA subjects with moderate vs mild osteolysis (Group 3b vs 3a) were more reactive to Co (43% vs 0% incidence). Wood MW, Warshaw EM. Neuro Endocrinol Lett. Due to ongoing chronic symptoms, CT scan incidentally revealed a portion of a lodged pigtail catheter in the cecum. Furthermore, there are few op Two weeks after gallbladder surgery, a 53-year-old man experienced constant abdominal pain in addition to nausea. 97100, 2017. These stages include removing the damaged tooth, bone grafting (if needed), dental implant placement, abutment placement, and the placement of your artificial tooth (crown). This a blood test that measures the immune response to titanium and is much more accurate than a traditional skin patch allergy test. 4, pp. Federal government websites often end in .gov or .mil. 1, pp. If you have history of metal allergy it may be recommended to have a MELISA test before you get an implant. cureus.com/articles/136554-diagnosis-and-management-of-a-hypersensitivity-reaction-to-titanium-containing-surgical-clips-a-case-report See MoreSee Less, Diagnosis and Management of a Hypersensitivity Reaction to Titanium-Containing Surgical Clips: A Case Report, Two weeks after gallbladder surgery, a 53-year-old man experienced constant abdominal pain in addition to nausea. Vaelentin-Thon E, Mller K, Guzzi G et al. Tested to NAC 80 panel and metal panel. The patient tolerated the procedure well with no postoperative complications. 1, pp. 12.5 microg/mL of chromium chloride and 50 ng/mL of potassium dichromate were found to be optimal to discriminate between sensitized individuals with and without allergy. 81-B, no. There is also no risk of allergic reactions, galvanic shock, or battery effects with ceramic like there is with metal implants. ii. 5. 201207, 2012. The suprastucture should overcome any metal of the abutments- eg. Mnchen, Germany. Oral Health, Dental Conditions & Treatments, Erythema (skin redness, in this case, in the tissues around the implant), Urticaria (hives that may be seen on the skin or gum surface), Eczema (itchy inflammation of the skin or gum tissue), Necrosis (death of cells or tissue, in this case, around the implant), Toxic reactions in other tissues, causing yellow nail syndrome (which can also affect the lungs and airways). P. H. Wu, J. H. Chen, and K. E. Chu, Successful endoscopic management of double iatrogenic perforations induced by endoscopic retrograde cholangiopancreatography and computed tomography-guided colon drainage, Case Reports in Gastroenterology, vol. Positive patch test to metal used in the implant Although extremly rare, allergic reaction is far more often seen in pure titanium implants then in titanium alloys of TiAlVa or Ti/Al/Niob or Molybden. Objectives: In candidates for hip or knee joint prosthesis implantation, to evaluate preoperative assessments for identifying patients with metal sensitivity, to determine the percentage of patients who developed metal sensitivity at 1 year after prosthesis implantation, and to examine the clinical relevance of patch tests and lymphocyte transformation tests (LTT-MELISA) for the evaluation of metal sensitization. Zirkonia crowns or bridge, and be cemented. New comments are currently closed for this post. About 6-8 months ago began with eczematoid/psoriatic rash most prominent over left knee (not present over right knee). He could breath but could not talk or actively move any muscle in his body. The striking features of titanium include its stability with increased resistance to corrosion and its biocompatibility to diverse materials [3]. Has been on chemotherapy for lung cancer and has had resection of cerebral tumor. However, it indeed seems titanium allergy had a significant role in her abdominal discomfort owing to her positive allergy test results further proving titanium hypersensitivity in this patient. Background: The standard assay for the detection of chromium sensitization, the patch test, does not allow discrimination between patients with and without clinical symptoms of allergy. The patients past surgical history includes a tonsillectomy, an appendectomy, and cholecystectomy. Yoshihisa, Yoko, and Tadamichi Shimizu. Even if a patient has a positive delayed type hypersensitivity skin test response, reactions to an orthopedic implant are rare and cannot be predicted The patient started having another episode of intermittent right lower quadrant (RLQ) pain starting in January 2020. We investigated these questions by measuring lymphocyte responses to implant metals (Cr+3, Co+2, Ni+2 at 0.1 mM, and Ti+4 at 0.001 mM) in six subject groups: Group 1a = young controls, Group 1b = age matched controls, Group 2a = subjects with osteoarthritis (OA) and no history of metal sensitivity, Group 2b = OA subjects with history of metal sensitivity, Group 3a = total hip arthroplasty (THA) subjects with no to mild radiographic osteolysis, and Group 3b = THA subjects with moderate osteolysis. Also, each product contains different ingredients and alloyes almost always contain some nickel or other allergent. In our case, the pigtail catheter was found as a retained surgical body lodged in the patients cecum. Although contact allergic reactions to titanium have been very rarely reported, these findings support a diagnosis of titanium allergy in our patient. 13, no. 2021, 2022 OsseoNews, Inc. All rights reserved. 7. I have found through the years that it is females that have these unusual allergies to metals. A question about this was submitted on Jan 9, 2013. The abdominal pain is associated with titanium allergy reaction from previously inserted titanium-based surgical clips. Additionally, standard surgical instruments such as electrodes, drains/catheters, retractors, or clamps can be left unrecognized after operations, especially in the abdominal space [13]. Although rare, metal allergies do occur and can occur with grade IV titanium as pure titanium is too brittle. There are 'allergies' that one can have to certain substances that don't cause you to break out in hives or go into anaphylactic shock. v. Positive in vitro test to metals Objective: The aim of this study was to prove whether cellular in vitro tests are predictive of chromium allergy. Abstract It's called Melisa. Metal hypersensitivity and Thirty-two patients reported that they followed the recommendations based on the results of the initial MELISA tests, and of these, 30 patients (94%) confirmed significant health improvement. Journal of Biomedical Materials Research PART A.
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