Silicone allergy in ventriculoperitoneal shunts

Jimenez, David F.; Keating, Robert; Goodrich, James Tait

doi:10.1007/bf00313586

Cited by 72 publications

(31 citation statements)

References 14 publications

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“…Jimenez et al reported on 3 patients with reaction and skin breakdown overlying the ventriculoperitoneal shunt. 5 The CSF was sterile in all 3 patients, and the histological studies of the surrounding tissues revealed acute and chronic inflammatory changes. Two of the patients had granulomas.…”

Section: Discussionmentioning

confidence: 89%

“…The authors postulated that the etiology of the process was an allergic localized reaction to the Silastic material of the shunt system. 5 Implantation of solid silicone materials is followed by the formation of fibrous tissue with a minimal inflammatory response, forming a "pseudocapsule," which is commonly seen around shunt tracks. Other forms of reaction to silicone materials have been described.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Solid noninfectious growing masses over cerebrospinal fluid shunts: report of 3 cases

James

Postlethwait

Sandler

2015

PED

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The authors describe 3 children who presented with progressively enlarging skin-covered solid masses over the shunt catheter in the neck/clavicular region. The authors reviewed the clinical, laboratory, pathological, radiographic, and follow-up data for all 3 patients and reviewed the literature on the subject. The patients had no clinical evidence of an infectious process. Surgical exploration revealed that masses were surrounding and encasing the shunt tubing to which they were strongly attached. Pathological studies of the tissues demonstrated varying degrees of exuberant chronically inflamed granulation tissues, interstitial fibrosis, and dystrophic calcification. One patient had associated thinning of the skin overlying the mass and subsequently developed ulceration. No infectious organisms were observed. The cerebrospinal fluid aspirates from the shunts did not yield any organisms. There has been no recurrence of the masses. The presence of a growing mass over the shunt tube in the neck or the chest region without clinical evidence of infection does not indicate that the mass should be treated with antibiotics and complete shunt removal. Rather, the mass can be cured by extirpation and with “bypass” new shunt tubing locally.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Solid noninfectious growing masses over cerebrospinal fluid shunts: report of 3 cases

James

Postlethwait

Sandler

2015

PED

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“…3 Jiminez et al suggested that the body may exhibit all of these reactions to silicone to some extent, depending on the patient's own cellular and humoral immune responses based on his or her human leukocyte antigen genotype. 3 With regard to calcification of VPS catheters in the subcutaneous tissues, 2 mechanisms have been described. One mechanism is metastatic calcification that presents with elevated levels of calcium and phosphate.…”

Section: Discussionmentioning

confidence: 99%

Intracranial calcified pseudocyst reaction to a shunt catheter

Yowtak¹,

Hughes²,

Heger³

et al. 2014

PED

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A 9-year-old boy with spina bifida, Chiari II malformation, and hydrocephalus presented with signs of increased intracranial pressure consistent with a shunt malfunction. Radiological investigations revealed an intracranial calcified lesion along the ventricular catheter. A shunt tap revealed a translucent milky white fluid. The patient underwent a ventriculostomy and, eventually, a shunt revision. Pathology findings were consistent with the formation of dystrophic calcification and a pseudocyst around the shunt catheter. Postoperatively, the patient returned to his neurological baseline. This is, to the best of the authors' knowledge, the first report of an intracranial calcified pseudocyst in a patient with normal renal function.

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“…There is a report with reference to silicon allergy; however, these children had recurrent skin breakdown over the shunt tract without any abdominal symptoms. [11] Since 1986, we are using latex-free gloves while inserting a VP shunt or excising pseudocysts in patients.…”

Section: Discussionmentioning

confidence: 99%