Autoimmune / Inflammatory Syndrome Induced by Adjuvants (Asia Syndrome) Associated with Silicone Breast Implant Rupture

Abstract

Background: Autoimmune/inflammatory syndrome (ASIA) constitutes a set of related immune mediated diseases that share a common clinical picture and a history of a previous exposure to an adjuvant agent. From a clinical standpoint, patients present with none specific manifestations such as myalgia, arthralgia, chronic fatigue and dry mouth as well as neurological manifestations such as cognitive disturbances, memory loss and neurologic disabilities. .Case presentation: A previously healthy 25-year-old patient who underwent breast augmentation 3 years ago, with an asymptomatic rupture of the silicone breast implant, presented with three major criteria of ASIA, and improved after bilateral implant removal. She also had pleuritis and pericarditis, rarely described in such disease. A literature review on complications related to breast implants, their questionable relationship to the onset of autoimmune pathologies, and basic aspects of the diagnosis and management of ASIA was carried out. Conclusion: The silicone presented in breast implants should be considered as an adjuvant, with the potential to cause chronic stimulation to the immune system. This can lead to systemic manifestations that can be severe in patients genetically predisposed and potentially not reversible even after surgical removal of the implants. When facing patients with breast implants and systemic clinical symptoms, lymph node disorders, neurological manifestations, or serositis as in the case presented, without other defined etiology, the possibility of ASIA should be considered in the differential diagnosis.

Pleural and pericardial effusion incidentally detected on breast magnetic resonance imaging in post-COVID-19 patients: retrospective case-control study

“…Клинически он проявляется неспецифи-ческими симптомами, такими как миалгия, артралгия, хроническая усталость и сухость во рту, когнитивные неврологические нарушения, потеря памяти, депрессия, парестезии, опухшие и чувствительные подмышечные лимфатические узлы, необъяснимая лихорадка, выпадение волос, головная боль и утренняя скованность [20]. У пациенток с грудными имплантатами ASIA Syndrome возникает в результате разрыва оболочки и попадания силикона в прямой контакт с иммунной системой хозяина [21]. Мы нашли в литературе описание двух случаев сочетания плеврита и перикардита при таком заболевании, 60-летней и 25-летней пациенток, у которых разрыв импланта протекал бессимптомно, но макрофагальное воспаление прилежащей области перикарда, плевральный выпот, а также поражение лимфатических узлов привело к необходимости удаления имплантов, после чего симптомы безвозвратно купировались [21,22].…”

“…У пациенток с грудными имплантатами ASIA Syndrome возникает в результате разрыва оболочки и попадания силикона в прямой контакт с иммунной системой хозяина [21]. Мы нашли в литературе описание двух случаев сочетания плеврита и перикардита при таком заболевании, 60-летней и 25-летней пациенток, у которых разрыв импланта протекал бессимптомно, но макрофагальное воспаление прилежащей области перикарда, плевральный выпот, а также поражение лимфатических узлов привело к необходимости удаления имплантов, после чего симптомы безвозвратно купировались [21,22]. Также имеются сообщения об изолированном развитии миоперикардита [23] и плеврита [24,25], вторичных по отношению к разрыву грудного импланта.…”

Classification for Staging and Managing Patients with Biopolymer-induced Human Adjuvant Disease

“…This study was carried out from the observational clinical follow-up of patients with BHAD since 2017. Different stages of the disease were noted that helped in surgical practice, enabling an understanding of the sequence of appearance of signs and symptoms, 6,7 positivity of immunological markers, and the natural course of the disease, taking into account the findings and consistency with the pathophysiology with which a disease staging scale shall be proposed (Tables 1–3). This is due to the fact that a gold standard has not yet been established that makes it possible to compare findings; however, the purpose of the present study was to explore the research field in relation to BHAD.…”

“…2 BHAD is a chronic clinical condition that requires surgical intervention as treatment in 100% of the affected population, regardless of whether they are symptomatic or asymptomatic, to minimize the risk of local and systemic sequelae and the risk of developing conditions that simulate the clinical course of disease of autoimmune etiology. 3 Through the study of the clinical and immunological nature of the disease, ASIA has certain criteria for its diagnosis, [4][5][6][7] but this does not enable staging of the degree of severity that guides the treatment required for the patient. Consequently, it is necessary to create a classification for BHAD on the basis of the nature of the disease that will make it possible to assess the damage and difficulty in the patients, leading to a more appropriate therapeutic approach.…”