Chronic urticaria from tantalum staples

We report herein the onset of chronic urticaria ten months after surgical implantation of tantalum staples. Intradermal testing with tantalum an urticarial response. The urticaria did not improve by treatment with antihistamines, but responded dramatically to disulfiram chelation therapy and resolved completely after surgical removal of the tantalum staples. We suspected a type 1 anaphylactic hypersensitivity to tantalum was present, but we have also considered that tantalum might have direct histamine releasing-like activity.