Autoimmune/inflammatory syndrome induced by adjuvants (ASIA), medical treatment of severe systemic compromise: case report
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Case description:
42-year-old woman with severe pulmonary and mediastinal inflammatory involvement, secondary to infiltration of a silicone-related allogenic material with systemic migration.
Clinical findings:
The patient developed esophageal and bronchial stenosis, recurrent infections, malnutrition, and respiratory deterioration, making surgical removal of the allogenic material impossible.
Treatment and outcome:
Clinical and radiological improvement was achieved after treatment with multiple intravenous and oral immunomodulators.
Clinical relevance:
Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a heterogeneous disease that results from exposure to allogenic substances in a subject with genetic susceptibility. These substances induce autoimmune or autoinflammatory phenomena. ASIA was recently described, and its diagnostic criteria are still under discussion. The prognosis of this syndrome is not clear, and its treatment is based on the elimination of the causing substance; however, this often does not improve the patient’s condition, and it is necessary to initiate immunomodulatory treatment. The treatment used in this patient was not previously described in the literature.
- Biopolymer
- autoimmunity
- immunomodulation
- ASIA syndrome
- Silicones
- Foreign Bodies
- Dimethylpolysiloxanes
Germán Eduardo Puerta Sarmiento, 1 Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia, 2 Universidad ICESI, Facultad de Medicina, Cali, Colombia
https://orcid.org/0000-0002-1915-2560
Inés Modragón, Universidad ICESI, Facultad de Medicina, Cali, Colombia
https://orcid.org/0000-0002-9439-7875
Alex Echeverri, Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia
https://orcid.org/0009-0002-5505-2257
Luz Fernanda Sua, Fundación clínica Valle del Lili, Departamento de Patología, Cali, Colombia.
https://orcid.org/0000-0001-9574-2370
Fabio Bonilla-Abadía, Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia
https://orcid.org/0000-0003-1683-1610
David Aguirre-Valencia, Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia
https://orcid.org/0000-0002-4935-8447
Siregar S, Groenwold RH, de Mol BA, Speekenbrink RG, Versteegh MI, Brandon Bravo Bruinsma GJ, et al. Evaluation of cardiac surgery mortality rates: 30-day mortality or longer follow-up. European Journal of Cardio-Thoracic Surgery. 2013 ;44:875-83. https://doi.org/10.1093/ejcts/ezt119 PMid:23471150 DOI: https://doi.org/10.1093/ejcts/ezt119
Bhukal I, Solanki SL, Ramaswamy S, Yaddanapudi LN, Jain A, Kumar P. Perioperative predictors of morbidity and mortality following cardiac surgery under cardiopulmonary bypass. Saudi J Anaesth. 2012;6:242-7. https://doi.org/10.4103/1658-354X.101215 PMid:23162397 PMCid:PMC3498662 DOI: https://doi.org/10.4103/1658-354X.101215
Hote M. Cardiac surgery risk scoring systems: In quest for the best. Heart Asia 2018;10: e011017. https://doi.org/10.1136/heartasia-2018-011017 PMid:29637928 PMCid:PMC5890060 DOI: https://doi.org/10.1136/heartasia-2018-011017
Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999; 16:9-13. https://doi.org/10.1016/S1010-7940(99)00134-7 PMid:10456395 DOI: https://doi.org/10.1016/S1010-7940(99)00134-7
Nashef SAM, Roques F, Michel P, Gauducheau E, De Vnicentiis C, Baudet E, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999; 15:816-22. https://doi.org/10.1016/S1010-7940(99)00106-2 PMid:10431864 DOI: https://doi.org/10.1016/S1010-7940(99)00106-2
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