Vargas Gutiérrez David Alejandro, Arias Callejas Karina Ivonne, Palacios Ruiz Edwin Pavel, Pérez Vinueza Priscila Joseline, Muñoz Vega Juan Diego, Mejía Geraldo Ana Karen G, Zaldívar Ingrid Salinas
Department of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, CDMX, Mexico.
Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, CDMX, Mexico.
Case Rep Hematol. 2022 May 24;2022:8571536. doi: 10.1155/2022/8571536. eCollection 2022.
Autoimmune/inflammatory syndrome induced by adjuvants is a disease associated with an unregulated hyperactivity of the immune system and may also be associated with a high frequency of hematologic malignancies. . This is a case of a female with ASIA-MO syndrome secondary to infiltration of mineral oil for aesthetic purposes and presented with multiple episodes of urolithiasis resulting in renal impairment of her left kidney confirmed by scintigraphy and ending in unilateral nephrectomy. Retrospective renal piece analysis confirmed tubulointerstitial infiltration with light chains and plasma cells. Paraffin fixation prevented subsequent immunofluorescence analysis for better follow-up of the patient.
The presence of positive immunofixation kappa chains explained the sudden deterioration of renal function with monoclonal gammopathy of renal significance which concluded in an association between diseases, such as multiple light chain myeloma, as a final diagnosis.
佐剂诱导的自身免疫性/炎症综合征是一种与免疫系统不受控制的过度活跃相关的疾病,也可能与血液系统恶性肿瘤的高发病率有关。这是一例因美容目的注射矿物油继发亚洲-肌肉骨骼病(ASIA-MO)综合征的女性病例,该患者多次发生尿石症,经闪烁扫描证实左肾肾功能受损,最终接受了单侧肾切除术。对切除的肾组织进行回顾性分析,证实存在轻链和浆细胞的肾小管间质浸润。石蜡固定妨碍了后续的免疫荧光分析,不利于对患者进行更好的随访。
免疫固定κ链阳性的存在解释了具有肾意义的单克隆丙种球蛋白病导致的肾功能突然恶化,最终诊断为多种疾病之间的关联,如多发性轻链骨髓瘤。