Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld's syndrome)

被引:57
作者
Vera-Lastra, O. [1 ,2 ]
Medina, G. [1 ,2 ]
del Pilar Cruz-Dominguez, M. [1 ,2 ]
Ramirez, P. [1 ]
Gayosso-Rivera, J. A. [1 ]
Anduaga-Dominguez, H. [1 ]
Lievana-Torres, C. [1 ]
Jara, L. J. [1 ,2 ]
机构
[1] Inst Mexicano Seguro Social, Hosp Especialidades Ctr Med Nacl La Raza, Mexico City, DF, Mexico
[2] Univ Nacl Autonoma Mexico, Mexico City 04510, DF, Mexico
关键词
ASIA; autoimmune rheumatic disease; foreign substances injection; human adjuvant disease; non-specific autoimmune manifestations; CONNECTIVE-TISSUE DISEASES; SILICONE BREAST IMPLANTS; SUBCUTANEOUS INJECTION; REVISED CRITERIA; CLASSIFICATION; ARTHRITIS; RISK;
D O I
10.1177/0961203311429317
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To investigate the clinical, laboratory and histological manifestations of patients who received illegal injections of foreign substances for cosmetic purposes. Patients and methods: We studied patients who met the following inclusion criteria: 1) history of application of foreign substances for cosmetic purposes, 2) clinical data of autoimmune disease or non-specific autoimmune manifestation (i.e. arthralgias, myalgia, malaise, fever, and weight loss), 3) detection of autoantibodies in patients' sera, 4) histological evidence of chronic inflammation and/or granulomatous reaction to foreign body. Results: Fifty female patients aged 44.4 +/- 10 years were studied. The mean time between application of foreign substances and onset of symptoms was 4.5 +/- 4.3 years. Patients were followed for 12 +/- 7.5 years. Forty-one patients were injected with mineral oil, nine patients received other substances: three iodine gadital, one guayacol, one guayacol plus silicone fluid, two collagen, two silicone fluid. The sites of application were: buttocks (36), legs and/or thighs (11), breasts (eight) hands and face (one), face (two) (seven patients received an injection to more than one site). Thirty patients presented with non-specific autoimmune manifestations, whereas 20 patients fulfilled the criteria for a defined autoimmune disease such as systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, overlap syndrome, autoimmune hemolytic anemia, autoimmune thyroiditis, autoimmune hepatitis, and ulcerative colitis. Conclusions: Cases of human adjuvant disease following illegal injections of oil substances for cosmetic purposes are reported. Patients presented with defined autoimmune diseases as well as with non-specific autoimmune manifestations. Illegal injection of these substances could lead to serious local and systemic complications, even to death. These cases represent another model of Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA). The use of these substances should be prohibited. Lupus (2012) 21, 128-135.
引用
收藏
页码:128 / 135
页数:8
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