Pachón S Jaime Eduardo, Salazar Marcela C, Pores Adriana M, Rizo Victor Z
Plastic and Reconstructive Surgery, Microsurgery Centro Medico Almirante Colon, Bogotá, Colombia.
Physician Private Practice, Bogotá, Colombia.
Plast Reconstr Surg Glob Open. 2021 Sep 24;9(9):e3796. doi: 10.1097/GOX.0000000000003796. eCollection 2021 Sep.
Biopolymers consist of non-biocompatible allogeneic materials. They have been associated with autoimmune inflammatory syndrome induced by adjuvants, as described by Yehuda Shoenfeld and Nancy Agmon-Levin. Therefore, this study aimed to evaluate the clinical and immunological characteristics of patients with autoimmune inflammatory syndrome induced by adjuvants treated at a plastic surgery clinic in Colombia.
This cross-sectional, descriptive observational study included 190 patients with biopolymers in the buttocks with no evidence of autoimmune disease who were diagnosed with autoimmune inflammatory syndrome induced by adjuvants and underwent treatment at a private plastic surgery clinic from 2017 to 2020. The clinical and paraclinical parameters were measured preoperatively, when the diagnosis of autoimmune inflammatory syndrome induced by adjuvants and the need for material removal were established, and postoperatively after 3 months.
The most frequent symptoms were myalgia (92%), arthralgia (77.9%), asthenia (77.9%), adynamia (77.9%), and neurological symptoms (55.8%). Preoperatively, patients were positive for antinuclear antibody, lactate dehydrogenase, complement proteins C3 and C4, and lupus anticoagulant. However, after removal of the biopolymer, there was a decrease in positivity or conversion to a negative status of paraclinical tests. Moreover, there was an association between LDH positivity and disease severity (odds ratio: 4.1, 95% confidence interval: 1.94-8.92).
The removal of biopolymers using an open surgical technique in symptomatic or asymptomatic patients is crucial for functional and reconstructive purposes and to improve the quality of life. Therefore, this condition should be known as "human adjuvant disease caused by biopolymers." Further, this condition mimics autoimmune diseases, with clinical and paraclinical manifestations that improve biopolymer removal.
生物聚合物由非生物相容性的同种异体材料组成。正如耶胡达·肖恩菲尔德和南希·阿蒙 - 莱文所描述的，它们与佐剂诱导的自身免疫性炎症综合征有关。因此，本研究旨在评估在哥伦比亚一家整形外科诊所接受治疗的佐剂诱导的自身免疫性炎症综合征患者的临床和免疫学特征。
这项横断面描述性观察研究纳入了190例臀部植入生物聚合物且无自身免疫性疾病证据的患者，这些患者被诊断为佐剂诱导的自身免疫性炎症综合征，并于2017年至2020年在一家私立整形外科诊所接受治疗。在术前（即确定佐剂诱导的自身免疫性炎症综合征诊断及需要取出材料时）以及术后3个月测量临床和辅助临床参数。
最常见的症状为肌痛（92%）、关节痛（77.9%）、乏力（77.9%）、活动障碍（77.9%）和神经症状（55.8%）。术前，患者的抗核抗体、乳酸脱氢酶、补体蛋白C3和C4以及狼疮抗凝物呈阳性。然而，在取出生物聚合物后，辅助临床检查的阳性率下降或转为阴性。此外，乳酸脱氢酶阳性与疾病严重程度之间存在关联（比值比：4.1，95%置信区间：1.94 - 8.92）。
对于有症状或无症状的患者，采用开放手术技术取出生物聚合物对于功能和重建目的以及改善生活质量至关重要。因此，这种情况应被称为“生物聚合物引起的人类佐剂病”。此外，这种情况类似于自身免疫性疾病，其临床和辅助临床表现在取出生物聚合物后会有所改善。
