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亚洲综合征:不良反应还是自身免疫?

ASIA syndrome: Adverse reaction or autoimmunity?

作者信息

André Diogo, Gouveia Fabiana, Nascimento Rafael, Luís Helena, Caldeira Mónica, Ferreira Caldeira, Chaves António José

机构信息

Internal Medicine, Hospital Central do Funchal, Madeira Island, Portugal.

Internal Medicine, Hospital da Luz, Madeira Island, Portugal.

出版信息

JRSM Open. 2022 Apr 4;13(4):20542704221086166. doi: 10.1177/20542704221086166. eCollection 2022 Apr.

Abstract

INTRODUCTION

Adjuvant-Induced Autoimmune / Auto-inflammatory Syndrome (ASIA) is an immune-mediated condition by the exposure of material previously considered inert, such as silicone, aluminum salts, mineral oils, hyaluronic acid and metallic implants. In addition to a genetic component, there is a risk of development of an undifferentiated connective tissue disease, which varies clinically and laboratorially depending on the adjuvant material used.

PATIENTS AND METHODS

This paper addresses two cases reported, in caucasian subjects, born and residents in Madeira Island, Portugal. In this article are described two different histological patterns occurring in ASIA patients, due to mammoplasty with silicone.

CONCLUSION

Although ASIA does not meet the diagnostic requirements for connective tissue disease, there is a close relationship with the development of autoimmune conditions. These cases aim to alert the medical community to the existence of this entity, encourage the notification of situations arising from exposure to adjuvants and investigate the presence of a genetic predisposition and a suggestive histological pattern in excisional biopsies of satellite adenomegalies.

摘要

引言

佐剂诱导的自身免疫/自身炎症综合征(ASIA)是一种由接触先前被认为惰性的物质(如硅酮、铝盐、矿物油、透明质酸和金属植入物)引起的免疫介导疾病。除了遗传因素外,还存在发展为未分化结缔组织病的风险,其临床和实验室表现因所使用的佐剂材料而异。

患者与方法

本文讨论了葡萄牙马德拉岛出生并居住的两名白种人患者的病例报告。本文描述了因硅胶隆乳术导致的ASIA患者出现的两种不同组织学模式。

结论

尽管ASIA不符合结缔组织病的诊断要求,但它与自身免疫性疾病的发生密切相关。这些病例旨在提醒医学界注意这一实体的存在,鼓励报告接触佐剂引起的情况,并调查卫星淋巴结切除活检中遗传易感性和提示性组织学模式的存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cac/8984841/e71bbde38cbf/10.1177_20542704221086166-fig1.jpg

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