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What's on TV tonight? German doctor diagnoses rare condition with help from TV's Dr. House

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LONDON - If you're unlucky enough to be stricken with a rare medical condition, you'd better hope your doctor watches the right television show.

That was the lesson for one German man with severe heart failure and a puzzling mix of symptoms including fever, blindness, deafness and enlarged lymph nodes, which baffled doctors for months.

The 55-year-old man was diagnosed only when he was referred to Dr. Juergen Schaefer, a fan of the U.S. television medical drama, "House."

"After five minutes, I knew what was wrong," said Schaefer, who works at the Center for Undiagnosed Diseases in Marburg, north of Frankfurt.

He said the man's symptoms matched up almost perfectly with a patient on an episode in which the fictional Dr. Gregory House, played by British actor Hugh Laurie, identified cobalt poisoning as the cause. The series ended in 2012 after an eight-year run.

Schaefer regularly uses the television series to teach medical students. When he saw the patient with heart failure in May 2012, he had recently prepared a lecture on the show's cobalt poisoning case, where House's future mother-in-law falls ill after receiving a faulty metal hip.

Though the German patient's previous doctors thought he needed a heart transplant, Schaefer and colleagues immediately tested his cobalt levels after he complained his problems started after his last operation to replace a broken ceramic hip.

Schaefer said some small fragments of the ceramic hip remained and were grinding into the metal replacement, which leaked cobalt and chromium into the patient's bloodstream. Once the hip was replaced, the patient's heart got better and his other symptoms improved.

Schaefer and colleagues wrote about their experience in a case report published online Friday in the journal, Lancet. The patient wasn't identified.

"We would have diagnosed this even without Dr. House," Schaefer said. "You could have also typed his symptoms into Google and gotten the diagnosis."

He said doctors should be aware of possible cobalt poisoning in patients with metal hip replacements.

While Schaefer said he is sometimes referred to as the German Dr. House, he isn't sure the nickname is a compliment. The television doctor was known as much for his rude, abrasive manner as for his expertise in diagnosing rare ailments.

"I would have fired this guy after the first three episodes," Schaefer said. Still, he said the fictional doctor's appalling bedside manner was ultimately outweighed by his unparalleled diagnostic skills.

"It's important to be nice, but you don't get patients healthy just by being nice."

____

Online:

Lancet journal: http://www.lancet.com

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