Acute Pneumonitis Presumed to be Silicone Embolism.

Matsuba, Tokuji; Sujiura, Tatsunari; Irei, M; Kyan, Yukio; Kunishima, Nobuyoshi; Uchima, Hisataka; Miyagi, S; Iwata, Yasushi; Matsuba, Kenichi

doi:10.2169/internalmedicine.33.481

Cited by 17 publications

(4 citation statements)

References 5 publications

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“…In 1991, the United States Food and Drug Administration (USFDA) issued guidelines prohibiting the marketing of injectable liquid silicone for any cosmetic purpose. The short-term effect of injected silicone is to enhance body shape [2][3][4][5][6][7] . The USFDA has since approved monitored clinical studies investigating the safety and efficacy of injectable silicone, but none has been completed as yet.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage and severe hypoxemic respiratory failure from silicone embolism

et al. 2010

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Liquid silicone is an inert material that may be used for cosmetic procedures by physicians as well as illegally by non-medical personnel. The use of silicone may result in severe complications, disfigurement, and even death. In addition, the indications for extracorporeal membrane oxygenation (ECMO) support have been increasing as a salvage therapy for a variety of life-threatening conditions. The patient is a 27-year-old woman with no significant medical conditions who developed silicone emboli, and subsequent diffuse alveolar hemorrhage after being injected with silicone in her gluteal region without medical supervision. She became profoundly hypoxemic and suffered a brief asystolic cardiac arrest in this setting. The patient was placed on veno-venous ECMO support for 14 days. Medical care during ECMO was complicated by pulmonary hemorrhage, hemothorax, pneumothorax, and blood clot, resulting in oxygenator change-out. A modified adult ECMO circuit (Jostra QuadroxD, Maquet Cardiopulmonary, Rastatt, Germany) was used to transport the patient from a nearby community affiliate hospital and then reconfigured for the medical intensive care unit on a standard HL-20 heart-lung console. Although the use of ECMO for severe hypoxemic respiratory failure has been widely reported, to our knowledge, this is the first reported successful use of ECMO for silicone embolism syndrome associated with diffuse alveolar hemorrhage and severe hypoxemic respiratory failure.

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Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage and severe hypoxemic respiratory failure from silicone embolism

et al. 2010

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“…The phenomenon is acute with symptoms presenting within 72 hours after injection in most cases, and the risk appears to increase with higher doses of silicone. The pathologic findings on lung biopsy include alveolar hemorrhage [10–12], silicone deposits within the alveoli [13], and inclusions within alveolar macrophages [7, 14, 15]. The biopsy of our patient revealed silicone infiltration with subsequent spillage into alveolar spaces.…”

Section: Discussionmentioning

confidence: 85%

Respiratory Disease following Illicit Injection of Silicone: A Case Report

Essenmacher

Astani²

2013

Case Reports in Medicine

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Unregulated, pseudomedical procedures risk serious sequelae even when otherwise safe compounds are used. Silicone is commonly used legally in cosmetic procedures owing to its durability, resistance to heat and aging, and low immunogenicity. However, inappropriate or illegal silicone injection can pose severe local and systemic complications including serious pulmonary compromise. We describe the case of a 30-year-old female who presented with hemoptysis and progressive shortness of breath following illicit silicone injections to the gluteal fat and was found to have new, diffuse, bilateral, ground-glass opacities on contrast-enhanced pulmonary computed tomography. Transbronchial biopsy elucidated that this was a lipoid pneumonia-type injury secondary to silicone infiltration.

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“…A case of acute pneumonitis following intramammary injections of a proprietary silicone fluid mixture has been described in 1994. 15 This seems to be a serious, potentially life-threatening illness and the pathogenesis has not yet been well established. The compound 1,2-benzisothiazolin-3-one is the active ingredient in proxel GXL, a commonly used preservative in many industries.…”

Section: Discussionmentioning

confidence: 99%

Human poisoning with spinosad and flonicamid insecticides

Lin

Lin-Tan

et al. 2011

Hum Exp Toxicol

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This report describes the first known case in the literature of acute exposure to a mixture of spinosad and flonicamid that resulted in a substantial clinical toxicities. An 80-year-old depressed female attempted suicide by drinking a mixture of 80-mL Conserve (Dow AgroSciences, Taipei, Taiwan) and 2–3 gram powder of flonicamid (Ishihara Sangyo Kaisha, Taipei, Taiwan). Spinosad was the main compound ingested. The clinical manifestations were mostly neurological, i.e. consciousness disturbance, shock, respiratory failure, pneumonitis and urinary retention. Endoscopic examination found grade 2a corrosive esophageal injury. After resuscitation, detoxification procedures and intensive care, the patient recovered fully without leaving any chronic sequels. An emerging question arising from this report is, why are the clinical symptoms so severe, given that both compounds were claimed safe in laboratory animals? The answer is unclear. One possible explanation is, the amount of spinosad ingested was far beyond the physiological safety dose that can be handled by human body. Other potential contributors to the clinical toxicities in this patient are the solvent compositions that were found in the Conserve insecticide formulation.

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Acute Pneumonitis Presumed to be Silicone Embolism.

Cited by 17 publications

References 5 publications

Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage and severe hypoxemic respiratory failure from silicone embolism

Extracorporeal membrane oxygenation for diffuse alveolar hemorrhage and severe hypoxemic respiratory failure from silicone embolism

Respiratory Disease following Illicit Injection of Silicone: A Case Report

Human poisoning with spinosad and flonicamid insecticides

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