title: Clinical peritonitis from allergy to silicone ventriculoperitoneal shunt.
abstract: Silicones are inorganic compounds that have been used for the purpose of shunting ventricular fluid since the mid-20th century [1]. Complications of ventriculoperitoneal shunts have rarely been attributed to silicone allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms. It can be diagnosed by detection of antisilicone antibodies and is treated with removal of the shunt and replacement, if needed, with a polyurethane shunt system. We report the first case of suspected silicone allergy presenting as clinical peritonitis without overt colonic perforation.
authors.affiliation: Department of General Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop St., Room N 715, Pittsburgh, PA, 15213, USA. kurinm@upmc.edu.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0001-6724-2985
authors.initials: M
authors.lastname: Kurin
authors.affiliation: Division of Gastrointestinal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Gardner
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Merritt
authors.initials: M
authors.lastname: Fajt
authors.affiliation: Department of General Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop St., Room N 715, Pittsburgh, PA, 15213, USA.
authors.forename: Chandraprakash
authors.initials: C
authors.lastname: Umapathy
authors.affiliation: Division of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fasanella
mesh_terms: D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D008875:Middle Aged; D010538:Peritonitis / Q000000981:diagnostic imaging / Q000209:etiology*; D012828:Silicones / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects* / Q000295:instrumentation
chemical_list: D012828:Silicones
keywords: Allergy; Peritonitis; Silicone; Ventriculoperitoneal shunt