2016
DOI: 10.1007/s12026-016-8871-1
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ASIA syndrome, calcinosis cutis and chronic kidney disease following silicone injections. A case-based review

Abstract: An immunologic adjuvant is a substance that enhances the antigen-specific immune response preferably without triggering one on its own. Silicone, a synthetic polymer used for reconstructive and cosmetic purposes, can cause, once injected, local and/or systemic reactions and trigger manifestations of autoimmunity, occasionally leading to an overt autoimmune disease. Siliconosis, calcinosis cutis with hypercalcemia and chronic kidney disease have all been reported in association with silicone injection. Here, we… Show more

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Cited by 22 publications
(7 citation statements)
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“…After silicone implantation, a capsule forms around the implant as part of an infammatory response to a foreign body, triggering a local reaction. However, in genetically susceptible individuals, this infammatory response may be uncontrolled, leading to the production of autoantibodies and occasionally an autoimmune disease with systemic repercussions [10,18]. Te exact underlying immunological mechanism is not known with certainty.…”
Section: Discussionmentioning
confidence: 99%
“…After silicone implantation, a capsule forms around the implant as part of an infammatory response to a foreign body, triggering a local reaction. However, in genetically susceptible individuals, this infammatory response may be uncontrolled, leading to the production of autoantibodies and occasionally an autoimmune disease with systemic repercussions [10,18]. Te exact underlying immunological mechanism is not known with certainty.…”
Section: Discussionmentioning
confidence: 99%
“…Through a cytokine-dependent inflammatory pathway, PTHrP may also be elevated. 10 Patients with SIH present with nonspecific symptoms of hypercalcemia, including fatigue, abdominal pain, cognitive decline, and weight loss in the context of previous cosmetic injections. 9 Guidelines for SIH are not standardized due to few reported cases and insufficient data supporting a definitive cure.…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…1,2,7,8 Systemically, granuloma formation secondary to silicone, termed siliconoma, rarely causes hypercalcemia through disordered production of 1,25-dihydroxycholecalciferol by activated macrophages similar to sarcoidosis. [8][9][10] Elevated calcitriol and serum calcium with suppressed PTH are hallmark laboratory findings. Through a cytokine-dependent inflammatory pathway, PTHrP may also be elevated.…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…Silicone as an adjuvant material has been long thought to be an inert material, and therefore has been used for more than 5 decades in medical implants including heart valves, testicular prostheses, intraocular lenses and breast implants. 39 Although considered otherwise safe, reports are emerging regarding the development of autoimmune-like phenomena in patients as well as animal models exposed to silicone. 40 Silicone as an adjuvant potentiates the immune response by promoting adaptive immune cell proliferation and cytokine release that leads to T cell proliferation and polarization.…”
Section: Silicone and Asia Syndromementioning
confidence: 99%