Severe Granulomatous Reaction Associated With Hypercalcemia Occurring After Silicone Soft Tissue Augmentation of the Buttocks: A Case Report

Abstract

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Calcitriol-mediated hypercalcemia secondary to granulomatous disease caused by soft-tissue filler injection: a case report

“…In granulomatous disorders, the calcitriol level is not suppressed due to an atypical production of 1-alpha-hydroxylase by macrophages. For example, the calcitriol levels in this patient and in previous case reports were "inappropriately" normal (Table 1) (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In this regard, normal calcitriol levels (25 -86,5 pg/mL) do not exclude calcitriol-mediated hypercalcemia.…”

“…Ketoconazole inhibits macrophage 1 alpha-hydroxylation of 25-OH-D3(25) and should be considered if the there is no response to glucocorticoids or if side effects occur (26); however, ketoconazole was not used in this case. Some case reports have suggested using other therapies such as calcitonin (12,27), a calcium-restricted diet (6), surgical resection (7,13,15), denosumab (12) and local injections of triamcinolone (12). Surgical resection is not recommended due to the extensive long-standing calcific deposits, and due to the extensive nature of the procedure.…”

“…Some soft-tissue filler (STF) injections can induce an inflammatory granulomatous effect of varying severity. In some cases, this reaction can lead to symptomatic, life-threating hypercalcemia (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Additionally, STFs are difficult to remove and may be associated with infectious complications such as cellulitis and even sepsis.…”

ASIA syndrome, calcinosis cutis and chronic kidney disease following silicone injections. A case-based review

“…The association between silicone injection, granulomas and hypercalcemia has been reported since 1984 [58], and there are several reports in the literature [59][60][61][62]. As for the other granulomatous diseases, hypercalcemia is likely the consequence of a dysregulated production of 1,25-dihydroxivitamin D by activated macrophages (induced by tumor necrosis factor-a and interferon-c, and inhibited by corticosteroids) [63] and/or an increase of PTHrP levels (stimulated by TNF-a and IL-6) [64].…”

The First Experience of Using Silicone Implants in the Augmentation Gluteoplasty in Tajikistan

“…Впервые эстетическую коррекцию ягодичной области выполнил Питангуй в 1964 г., а Бартлес в 1969 г. впервые выполнил аугментацию ягодиц путём вставления грудных протезов в ягодичную область [6]. С тех пор для улучшения формы ягодиц стали широко применяться различные операции: липосакция, пересадка жировой ткани, лоскутные пластики и аугментация при помощи силиконовых протезов [7][8][9][10][11][12][13][14].…”