Visnyei Koppany, Samuel Maria, Heacock Laura, Cortes Jose A
Department of Internal Medicine, Beth Israel Medical Center, Albert Einstein College of Medicine, 1st Ave at 17th St, Baird Hall, 20th Floor, New York, NY 1000, USA.
J Med Case Rep. 2014 Feb 26;8:71. doi: 10.1186/1752-1947-8-71.
Body contouring injections by non-licensed providers are frequently sought out by a subset of the male-to-female transgender community. Although short-term side effects such as pulmonary embolism and injection site infection are well known, long-term consequences of such practices are less well studied.
Here we describe the case of a 40-year-old African American male-to-female transgender patient who presented to our institution with hypercalcemia and acute renal failure secondary to body contouring injections with industrial strength silicone by non-licensed providers, a decade prior to her visit. Work-up revealed an extensive granulomatous inflammatory process in the injection area resulting in electrolyte abnormalities and kidney injury. The patient's lab results and symptoms responded well to long-term corticosteroid treatment and correlated with treatment adherence.
Affected patients can sometimes present with unusual clinical symptoms many years after silicone injections. In a constantly growing transgender community that often utilizes non-licensed providers for silicone injections, the medical community will likely face an increasing number of patients with long-term side effects of such practices. Therefore, it is imperative for physicians to recognize such cases promptly and initiate potentially life-saving treatment.
一部分男变女跨性别群体经常寻求非持牌医疗人员进行身体塑形注射。虽然诸如肺栓塞和注射部位感染等短期副作用广为人知,但此类行为的长期后果研究较少。
在此,我们描述一名40岁非裔美国男变女跨性别患者的病例,该患者在就诊前十年,由非持牌医疗人员使用工业强度硅胶进行身体塑形注射后,出现高钙血症和急性肾衰竭,并前来我院就诊。检查发现注射部位存在广泛的肉芽肿性炎症过程,导致电解质异常和肾损伤。患者的实验室检查结果和症状对长期皮质类固醇治疗反应良好,且与治疗依从性相关。
受影响的患者在硅胶注射多年后有时会出现不寻常的临床症状。在一个不断壮大且经常利用非持牌医疗人员进行硅胶注射的跨性别群体中,医学界可能会面临越来越多有此类行为长期副作用的患者。因此,医生必须及时识别此类病例并启动可能挽救生命的治疗。