title: Distal ventriculoperitoneal shunt failure caused by silicone allergy. Case report.
abstract: The placement of a ventriculoperitoneal (VP) shunt is the most common form of treatment for hydrocephalus. Although allergic reactions to the silicone in shunt hardware are very rare, the authors describe a case of silicone allergy causing multiple ventricular shunt revisions. A 24-year-old man, who had undergone multiple VP shunt revisions, presented with shunt malfunction caused by allergic reaction of the tissues surrounding the shunt tubing. The patient's existing silicone-based shunt was replaced with a new polyurethane system, including the proximal and distal catheters as well as the valve mechanism. Contrary to recommendations in previous studies of silicone shunt allergies, long-term immunosuppression was not initiated. The patient was followed up for more than 8 years without recurrence of an allergic reaction to the shunt. This outcome indicates that replacing the original silicone-based shunt system with a polyurethane-based system alone is sufficient in the treatment of a silicone shunt allergy.
authors.affiliation: Department of Neurological Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: Namath S
authors.initials: NS
authors.lastname: Hussain
authors.forename: Paul P
authors.initials: PP
authors.lastname: Wang
authors.forename: Carol
authors.initials: C
authors.lastname: James
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Carson
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Avellino
mesh_terms: D000328:Adult; D004342:Drug Hypersensitivity / Q000150:complications*; D004868:Equipment Failure; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy; D008297:Male; D011140:Polyurethanes; D012828:Silicones / Q000009:adverse effects*; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*
chemical_list: D011140:Polyurethanes; D012828:Silicones