Cobalt has been linked to the development of cancers. As our patient also has the diagnosis of Charcot Marie Tooth, it is important to prevent anchoring heuristic bias and evaluate the patient from fresh eyes especially with a history of MoM device placement.Ĭonclusion: The symptoms did resolve on removing the MoM device which does imply that PHACT can be regarded closer to a fact when compared to a fiction. It is toxic to the lungs, eyes, skin, and heart. Resolution of the symptoms with concomitant decrease in serum cobalt was noted.ĭiscussion: PHACT being a diagnosis which is rare and done by exclusion, it is important to make it a part of the differential diagnosis. After an extensive work up was performed and reviewing current literature, serum cobalt level was eventually performed and was found to be high. He presented to PCP with progressive worsening of muscle weakness, fatigue and tremor of two months duration. Cobalt is a sensitizer in humans by any route of exposure. National Center for Environmental Assessment. There are few reports of PHACT and only one case report from our review that reported tremor as a presenting symptom (7).Ĭase presentation: This is a report of a 44 year old male with history of hip replacement. The MOE would be 270 when calculated from its non-toxic level of 0.001 mg/m3 and the predicted maximum exposure concentration, and divided by a factor of 5. Provisional Peer Reviewed Toxicity Values for Cobalt (CASRN ) Superfund Health Risk Technical Support Center.

Introduction and objective: Prosthetic hip-associated cobalt toxicity (PHACT) is a rare cause of cobalt toxicity from metal-on metal (MoM) total hip prosthesis.

Cobalt toxic