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

Abstract

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.

• Authors: O Vera-Lastra, G Medina, M del Pilar Cruz-Dominguez, P Ramirez, J A Gayosso-Rivera, H Anduaga-Dominguez, C Lievana-Torres, L J Jara
• Journal: Lupus (Lupus) Vol. 21 Issue 2 Pg. 128-35 (Feb 2012) ISSN: 1477-0962 [Electronic] England
• PMID: 22235042 (Publication Type: Journal Article)

Chemical References

• Adjuvants, Pharmaceutic

Topics

• Adjuvants, Pharmaceutic (adverse effects)
• Adolescent
• Adult
• Autoimmune Diseases (chemically induced, immunology, pathology, physiopathology)
• Cosmetic Techniques (adverse effects, ethics)
• Female
• Foreign Bodies (immunology)
• Humans
• Middle Aged
• Syndrome
• Young Adult