[佐剂诱导的自身免疫性/炎症综合征。病例报告]
[Autoimmune/inflammatory syndrome induced by adjuvants. Case report].
作者信息
Moreno-Urbina Sergio Ignacio, Gameros-Palma Carla Paola, Ramos-Estrada Jorge Gaspar, Hiracheta-Torres Alberto
机构信息
Instituto Mexicano del Seguro Social, Hospital General Regional No. 1, Servicio de Hematología. Chihuahua, Chihuahua, México.
Universidad Autónoma de Chihuahua, Facultad de Medicina y Ciencias Biomédicas, Departamento de Medicina. Chihuahua, Chihuahua, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2023 Mar 1;61(2):251-255.
BACKGROUND
The indiscriminate application of substances for aesthetic purposes, such as silicone in breast implants, leads to the production of common local signs such as inflammation, skin irregularities, edema, erythema, vascular neoformations, and ulcers, which can evolve into general symptoms such as fever, asthenia, weakness, arthralgia or activate the immune system abnormally, causing the appearance of autoimmune diseases. This set of signs and symptoms is called adjuvant-induced autoimmune/inflammatory syndrome.
CLINICAL CASE
We present the case of a 50-year-old woman with a history of silicone-based breast implants who spontaneously developed a hemorrhagic coagulopathy, type A acquired hemophilia was documented, that is, autoantibodies against coagulation factor VIII. Thanks to the work of a multidisciplinary team, it is possible to successfully diagnose and treat the patient with bridging agents, implant removal and management of associated symptoms.
CONCLUSION
the importance of knowing the pathology is recognized, which, although it is rare, when it occurs has a high mortality rate if it is not diagnosed and treated on time.
背景
出于美容目的随意使用某些物质，如乳房植入物中的硅胶，会导致常见的局部症状，如炎症、皮肤异常、水肿、红斑、血管新生和溃疡，这些症状可能会演变为全身症状，如发热、乏力、虚弱、关节痛，或异常激活免疫系统，导致自身免疫性疾病的出现。这一系列体征和症状被称为佐剂诱导的自身免疫/炎症综合征。
临床病例
我们报告一例50岁女性病例，该患者有硅胶乳房植入史，自发出现出血性凝血病，确诊为A型获得性血友病，即针对凝血因子VIII的自身抗体。多亏了多学科团队的努力，才得以成功诊断并使用桥接剂治疗该患者，切除植入物并处理相关症状。
结论
认识到了解这种病理学的重要性，尽管它很罕见，但如果不及时诊断和治疗，一旦发生则死亡率很高。
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