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For Healthcare Professionals
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Patients with symptoms of profound fatigue and pain of unclear aetiology (Chronic Fatigue Syndrome, Myalgic Encephalitis, Fibromyalgia) often suffer from metal allergy induced by dental metals and metals  from orthopedic implants.

Avoidance of allergens often results in significant health improvement for the patient. Follow-up MELISA®  testing usually shows reduced lymphocyte reactivity as well.


Implants such as hip joints, knee prosthesis, and pacemakers contain metals such as chromium, cobalt, gold, nickel and titanium. In the majority of patients, these implants are biocompatible. However, in sensitive patients, the implants may have side-effects such as pain, dermatitis, cutaneous swelling, impaired wound healing, bone infections and implant loosening. Where bacterial infection can be ruled out and there is still inflammation metal allergy can be considered.

Metal-on-Metal (MoM) hip joints produce small amounts of metal wear over time. This gradual metal wear may cause adverse reactions in patients with metal allergies.

Nickel, cobalt, gold and chromium are well known metal allergens. Recently, cases of titanium allergy have also been described in scientific literature. Titanium is a transition metal and thus may function as a hapten and trigger cellular hypersensitivity. Since titanium is used as white pigment in toothpastes, cosmetics and medication the latent sensitization of susceptible individuals is possible. Case reports convey disappearance of symptoms after the removal of the implant and positive delayed-type reactions are confirmed by patch-testing or by decreased lymphocyte proliferation to specific metal allergens in vitro.

MELISA® screening may be performed prior to surgical implantation and it can detect the possible existence of sensitization and allow the use of biocompatible implants tailored to each individual patient.

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