ASIA syndrome, calcinosis cutis and chronic kidney disease following silicone injections. A case-based review.
An immunologic adjuvant is a substance that enhances the antigen-specific immune response preferably without triggering one on its own. Silicone, a synthetic polymer used for reconstructive and cosmetic purposes, can cause, once injected, local and/or systemic reactions and trigger manifestations of autoimmunity, occasionally leading to an overt autoimmune disease. Siliconosis, calcinosis cutis with hypercalcemia and chronic kidney disease have all been reported in association with silicone injection. Here, we describe a case of autoimmune/auto-inflammatory syndrome induced by adjuvants, calcinosis cutis and chronic kidney disease after liquid silicone multiple injections in a young man who underwent a sex reassignment surgery, followed by a review of the literature. To our knowledge, this is the first report describing the concomitance of the three clinical conditions in the same patients. The link between silicone and the immune system is not completely understood yet and requires further reports and investigations with long-term data, in order to identify the main individual and genetical risk factors predisposing to the wide spectrum of the adjuvant-induced responses.
Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy. giuseppe.barilaro@uniroma1.it.
Giuseppe
0000-0003-2085-0099
G
Barilaro
Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Claudia
C
Spaziani Testa
Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Antonella
A
Cacciani
Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Giuseppe
G
Donato
Nephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Mira
M
Dimko
Nephrology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00161, Rome, Italy.
Amalia
A
Mariotti
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000175:diagnosis*; D002114:Calcinosis / Q000139:chemically induced / Q000175:diagnosis*; D002908:Chronic Disease; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007267:Injections; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D057830:Gender-Affirming Surgery; D012828:Silicones / Q000008:administration & dosage / Q000009:adverse effects*; D012867:Skin / Q000276:immunology / Q000473:pathology*; D013577:Syndrome
D000276:Adjuvants, Immunologic; D012828:Silicones
ASIA syndrome; Calcinosis cutis; Chronic kidney disease; Hypercalcemia; Siliconosis
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