Although titanium allergies are not commonly diagnosed, they can present with a variety of conditions years after the implantation of titanium-containing medical devices. Furthermore, there are few options to effectively manage the long-term outcomes of these conditions. We present the case of a 41-year-old female who experienced neck swelling, pain, and difficulty swallowing 16 years after a right thyroid lobectomy for benign follicular adenoma, requiring the implantation of titanium-containing surgical clips in her neck. This was accompanied by an extensive symptomatic history, and the patient showed mild reactivity to nickel and titanium on a metal lymphocyte transformation test analysis. X-ray and computed tomography of the neck later confirmed the location of 18 surgical clips. The patient was diagnosed with a chronic immune disease including immune complex disease and mast cell activation-related symptoms. Symptoms were managed with low-dose naltrexone until the surgical clips were removed. Further research is needed to identify more accurate testing methods to diagnose titanium hypersensitivity. Alternative treatment methods should be explored to reduce disease burden and complications related to titanium-containing implants.
Keywords: case report; hypersensitivity; low-dose naltrexone; melisa; metal-ltt; patch testing; titanium allergy.
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