When uncommon and common coalesce: adult onset Still’s disease associated with breast augmentation as part of autoimmune syndrome induced by adjuvants (ASIA)

Dagan, Amir; Kogan, Michael; Shoenfeld, Yehuda; Segal, Gad

doi:10.1007/s10067-015-2869-2

Cited by 26 publications

(6 citation statements)

References 30 publications

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“…These autoantibodies may predict and precede the development of autoimmune disease in these women. The complex link between SBIs and autoimmunity can be illustrated by the concept of ASIA syndrome [ 1 , 48 , 49 , 63 ]. Recently, our group has diagnosed almost 100 women with SBIs, suffering from classical ASIA-related, non-specific, diverse clinical manifestation as: chronic fatigue, sleep disturbance, widespread pain, memory loss, dry mouth and eye, cognitive impairment, tachycardia, hearing abnormalities, allergic reaction, depression, hair loss, irritable bladder and bowel syndrome, palpitations etc.…”

Section: Classical Examples Of the Asia Syndromementioning

confidence: 99%

Classical Examples of the Concept of the ASIA Syndrome

et al. 2020

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Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. In this review, five enigmatic conditions, including sarcoidosis, Sjögren’s syndrome, undifferentiated connective tissue disease, silicone implant incompatibility syndrome (SIIS), and immune-related adverse events (irAEs), are defined as classical examples of ASIA. Certainly, these disorders have been described after an adjuvant stimulus (silicone implantation, drugs, infections, metals, vaccines, etc.) among genetically predisposed individuals (mainly the HLA-DRB1 and PTPN22 gene), which induce an hyperstimulation of the immune system resulting in the production of autoantibodies, eventually leading to the development of autoimmune diseases. Circulating autonomic autoantibodies in the sera of patients with silicone breast implants, as well as anatomopathological aspects of small fiber neuropathy in their skin biopsies have been recently described. To our knowledge, these novel insights serve as a common explanation to the non-specific clinical manifestations reported in patients with ASIA, leading to the redefinition of the ASIA syndrome diagnostic criteria.

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Section: Classical Examples Of the Asia Syndromementioning

confidence: 99%

Classical Examples of the Concept of the ASIA Syndrome

et al. 2020

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“…In our patient there was a previous history of probable systemic onset juvenile idiopathic arthritis, who in adolescence received SBI and later developed AOSD. With regard to this disease there are some case reports attributed to SBI [23,24].…”

Section: Resultsmentioning

confidence: 99%

Autoimmune/Inflammatory Syndrome Induced by Silicone Breast Implant and Risk Factors Associated to Autoimmune Diseases

Vera‐Lastra¹,

Mp²,

G³

et al. 2019

Rheumatology

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Autoimmune Rheumatic Diseases (ARD) have been associated with Silicon Breast Implant (SBI) as part of the spectrum of Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA). Silicone is an adjuvant that may bleed and subsequently may be a chronic stimulus to the immune system. Objective: To determine the prevalence of autoimmune diseases (AID) and risk factors associated to patients with ASIA induced by SBI (ASIA-SBI). Patients and methods: This study was performed between 2012 and 2018, in a tertiary referral center, from a cohort of 210 patients with ASIA. We selected those patients with ASIA-SBI and clinical manifestations of any ARD. We investigated family history of AID, smoking, allergies and comorbidities. Statistical analysis: Chi square and Odds Ratio (OR). Results: There were 45 women with current age 50 (29-75) years, mean time of appearance of clinical manifestations after SBI was 8.8 ± 5.5 years. We found systemic sclerosis (SSc) 10 patients, rheumatoid arthritis (RA) 8, undifferentiated connective tissue syndrome (UCTDS) 6, fibromyalgia (FM) 5, systemic lupus erythematosus (SLE) 4, Sjogren syndrome (SS) 3, angioedema/urticaria 3, overlap syndrome 2, and one of each of the following: Takayasu arteritis, Still disease, tunnel carpal syndrome and antiphospholipid syndrome. We observed family history of ARD 42%, allergy history 37.5% and smoking 35.5%. In ASIA-SBI patients, family history and smoking had a significant association with SSc OR 6.0 (CI 1.2-29), p<0.02 and RA OR 7.1 (CI 1.3-37.2), p<0.022. Conclusions: In patients with ASIA-SBI, family history of AID and smoking were associated with SSc and RA. In addition to SBI, environmental and genetic factors should be taken into account for the development of AID.

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“…There are no medications that can cure ASIA, but therapy can reduce symptoms [ 9 ]. The objective of surgical treatment is to remove most of the material to improve ASIA syndrome evolution [ 14 ]. The more substance is left, more relapses will appear and multiple secondary surgeries will be the rule; so, the complexity of the reconstructive procedure depends on the affected area, the dissemination of substances and the severity of the lesions.…”

Section: Introductionmentioning

confidence: 99%

Disease presentation and surgical treatment of patients with foreign-body granulomas and ASIA syndrome: case series

et al. 2021

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Background The result of illicit polymer injection is chronic inflammation with foreign-body granuloma (FBG) formation. Treatment can be divided into medical and surgical. Some patients develop severe complications with need surgical treatment. This study aims to describe patients who underwent surgical removal of the FBGs and autoimmune/inflammatory syndrome induced by adjuvants (ASIA); additionally, we evaluated the quality of life after surgery.Methods In this retrospective single-center study, the authors examined data of patients who underwent surgical removal of FBG caused by illicit polymer injection for cosmetic purposes and confirmed ASIA from 2015 to 2020 by three different surgical approaches. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, treatment strategies, histopathology reports and quality of life.Results The cohort included 11 female patients with FBGs and ASIA. The most affected anatomical zones were the combination of gluteal region, thighs and legs (40%); and thighs with legs (20%). Main presentation was: skin hyperpigmentation (90.9%), skin induration (63.6%), chronic fatigue (63.6%), and ulcers (36.4%). Surgical modalities consisted of: ultrasonic-assisted liposuction in four patients (36.4%); open en bloc excision and primary closure in four patients (36.4%); and open en bloc excision and microsurgical reconstruction in three patients (27.2%). The postoperative quality of life visual analog scale score was 83.9.Conclusions ASIA treatment represents a challenge for the plastic surgeon. Adequate surgical treatment emphasizing, when possible, the total or near-total resection of the FBG must be performed to improve ASIA evolution.

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When uncommon and common coalesce: adult onset Still’s disease associated with breast augmentation as part of autoimmune syndrome induced by adjuvants (ASIA)

Cited by 26 publications

References 30 publications

Classical Examples of the Concept of the ASIA Syndrome

Classical Examples of the Concept of the ASIA Syndrome

Autoimmune/Inflammatory Syndrome Induced by Silicone Breast Implant and Risk Factors Associated to Autoimmune Diseases

Disease presentation and surgical treatment of patients with foreign-body granulomas and ASIA syndrome: case series

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