Case Letter
ASIA case after injection of liquid silicone
Read
5776
Timeswas read the article
2785
Total PDF
2991
Total HTML
Share statistics
array:24 [ "pii" => "S0365059620301367" "issn" => "03650596" "doi" => "10.1016/j.abd.2019.12.006" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "208" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:19 [ "pii" => "S2666275220301983" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.05.008" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "208" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta – Caso clínico</span>" "titulo" => "Caso de ASIA após injeção de silicone líquido" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "542" "paginaFinal" => "544" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 680 "Ancho" => 905 "Tamanyo" => 179682 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Exame histopatológico evidencia histiócitos xantomizados, sugere reação a corpo estranho (Hematoxilina & eosina, 40×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Camila Secco Libardi, Lucia Martins Diniz, Carlos Musso, Bruna Anjos Badaró" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Camila Secco" "apellidos" => "Libardi" ] 1 => array:2 [ "nombre" => "Lucia Martins" "apellidos" => "Diniz" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Musso" ] 3 => array:2 [ "nombre" => "Bruna Anjos" "apellidos" => "Badaró" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059620301367" "doi" => "10.1016/j.abd.2019.12.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620301367?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220301983?idApp=UINPBA00008Z" "url" => "/26662752/0000009500000004/v2_202008070652/S2666275220301983/v2_202008070652/pt/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0365059620301409" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.02.004" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "212" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "cor" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondence</span>" "titulo" => "On variations in micrographic surgery and the use of horizontal histological sections in the evaluation of the surgical margin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "545" "paginaFinal" => "546" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Anna Carolina Miola, Hélio Amante Miot, Luis Fernando Figueiredo Kopke" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Anna Carolina" "apellidos" => "Miola" ] 1 => array:2 [ "nombre" => "Hélio Amante" "apellidos" => "Miot" ] 2 => array:2 [ "nombre" => "Luis Fernando Figueiredo" "apellidos" => "Kopke" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220302101" "doi" => "10.1016/j.abdp.2020.02.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302101?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620301409?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000004/v3_202008041755/S0365059620301409/v3_202008041755/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059620301276" "issn" => "03650596" "doi" => "10.1016/j.abd.2019.11.010" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "199" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "sco" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "Acute generalized exanthematous pustulosis with features mimicking toxic epidermal necrolysis secondary to amiodarone" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "540" "paginaFinal" => "542" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 941 "Ancho" => 755 "Tamanyo" => 126336 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Bullous lesions that led to small erosions on flanks.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cheryl Distel, María Luz Bollea Garlatti, Ana Clara Torre, Julia Riganti" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Cheryl" "apellidos" => "Distel" ] 1 => array:2 [ "nombre" => "María Luz" "apellidos" => "Bollea Garlatti" ] 2 => array:2 [ "nombre" => "Ana Clara" "apellidos" => "Torre" ] 3 => array:2 [ "nombre" => "Julia" "apellidos" => "Riganti" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220302010" "doi" => "10.1016/j.abdp.2020.05.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302010?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620301276?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000004/v3_202008041755/S0365059620301276/v3_202008041755/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Letter</span>" "titulo" => "ASIA case after injection of liquid silicone" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "542" "paginaFinal" => "544" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Camila Secco Libardi, Lucia Martins Diniz, Carlos Musso, Bruna Anjos Badaró" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Camila Secco" "apellidos" => "Libardi" "email" => array:1 [ 0 => "camilaslibardi@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Lucia Martins" "apellidos" => "Diniz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Carlos" "apellidos" => "Musso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Bruna Anjos" "apellidos" => "Badaró" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sector of Dermatology, Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1299 "Ancho" => 905 "Tamanyo" => 102162 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lateral view of left thigh. Hardened, brownish, scaly plaque.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The appreciation for physical beauty goes back to ancient times. The 20th century brought great changes, with its demanding socioeconomic requirements, influenced by the industrial and petrochemical revolutions, in addition to the ancient human passion: the search for aesthetic perfection.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In 1948, silicone, considered immunologically inert, aroused the interest of the medical community due to the need for biocompatible surgical materials,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> gaining importance in cosmiatry. However, from the 1990s, cases of connective tissue disease began to appear in patients with silicone implants, exhibiting fibrous tissue reactions similar to scleroderma. The relationship between silicone implants and appearance of nonspecific symptoms that do not meet diagnostic criteria for connective tissue disease suggests that an undefined syndrome may occur due to silicone exposure.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The analyses of these manifestations led to the definition known as siliconosis, which includes the following: myalgia; abnormal fatigue; cognitive impairment; depression; dry eyes and mouth; skin abnormalities; paresthesias; oedema and sensitivity in axillary glands; fever of undetermined origin; alopecia; headache; morning stiffness.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In recent years, in addition to siliconosis, three other diseases characterized by overactive immune responses have been described, namely: Gulf War syndrome, macrophagic myofasciitis, and post-vaccination phenomena. Since these diseases share a similar set of signs and symptoms, they were condensed by Shoenfeld and Agmon-Levin in 2011 under the term ASIA: autoimmune/inflammatory syndrome induced by adjuvants.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> By definition, a case of ASIA characterizes symptoms and systemic signs or autoimmune disease, developed after exposure to external stimuli, with production of antibodies against the adjuvant involved. The diagnostic criteria are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">table 1</a>.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> These criteria have not yet been validated; therefore, there is no consensus in the literature about how many of them should be present for the diagnosis of ASIA. In their cohort, Watada et al. included patients with at least one major, or one major and one minor criteria as cases of the syndrome.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">In the present case, a 49-year-old woman had received injections of liquid silicone into the buttocks ten years before seeking care. Painful, brownish, hard plaques had appeared on the lateral aspect of the left thigh two years previously (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The lesions evolved into spontaneous outbreaks and remissions, and emerged concurrently with inflammatory arthralgia and asthenia of the hand and wrist. Complementary exams indicated rheumatoid factor 523, ANA 1:80 nuclear fine speckled pattern (remaining rheumatologic panel indicated normal results), corroborating the diagnosis of rheumatoid arthritis. Histopathological analysis of cutaneous lesion indicated chronic inflammatory reaction with xanthomized histiocytes (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and negative acid-fast bacillus (AFB) smears. Treatment with methotrexate was started, controlling the cutaneous lesions and the joint condition.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">This report presents three major criteria (silicon exposure; systemic symptoms of asthenia and arthralgias; histopathological exam indicating chronic inflammation), and two minor criteria (onset of rheumatoid arthritis and autoantibodies). Thus, it met the criteria for the diagnosis of the syndrome, which has an uncertain prognosis due to the fact that it is a relatively new concept.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Vera-Lastra et al. analyzed 50 cases of patients submitted to injections of various materials. Inclusion criteria were the following: history of injectable procedures; autoimmune disease/nonspecific manifestations; autoantibodies; histological evidence of chronic inflammation; and absence of infections/neoplasms that explained the picture. The average time between the injections and the onset of the symptoms was around four years (one month to 15 years), with 60% of the patients exhibiting nonspecific autoimmune manifestations, and 8% developing rheumatoid arthritis. According to the histological exam, there were granulomas, chronic inflammation, oil vacuoles, and fibrosis in the injection area,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleItalic">i.e.</span>, findings similar to those of the present case.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Regarding management, Tervaert et al. suggested the following: correction of hypovitaminosis D, if present; reduction of exposure to triggers such as allergic reactions and respiratory tract infections; and smoking cessation. When possible, the involved adjuvant should be surgically removed. In addition, if necessary, medications such as oral or intravenous doxycycline, minocycline, hydroxychloroquine, and corticosteroids should be prescribed.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The present case demonstrates that it is essential to know the patient's symptoms and comorbidities before the injection of adjuvant substances, in order to determine and recognize ASIA, a recently defined syndrome that will have a very persistent future, given the growing demand for injectable procedures. Aware of these data, physicians will be able to avoid the onset of chronic diseases with great impact, which might adversely affect patient's health. Moreover, one more question remains: What other materials, now considered biocompatible (as silicone had once been), could trigger ASIA in the near future? Prospective and retrospective studies could illustrate the ASIA phenomenon within the next decades, providing answers and, possibly, further questions.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financial support</span><p id="par0070" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Camila Secco Libardi: Conception and planning of the study; drafting and editing of the manuscript; critical review of the literature.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Lucia Martins Diniz: Approval of final version of the manuscript; conception and planning of the study; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Carlos Musso: Approval of final version of the manuscript; collection, analysis, and interpretation of data; critical review of the manuscript.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Bruna Anjos Badaró: Conception and planning of the study; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-17" "fechaAceptado" => "2019-12-31" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Libardi CS, Diniz LM, Musso C, Badaró BA. ASIA case after injection of liquid silicone. An Bras Dermatol. 2020;95:542–4.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Hospital Universitário Cassiano Antônio Moraes, Vitória, ES, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1299 "Ancho" => 905 "Tamanyo" => 102162 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lateral view of left thigh. Hardened, brownish, scaly plaque.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 680 "Ancho" => 905 "Tamanyo" => 179682 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histopathologic study. Histopathological examination shows xanthomized histiocytes, suggesting reaction to a foreign body.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ABD suggested criteria for ASIA diagnosis \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Major criteria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exposure to external stimuli (infection, vaccine, silicone, adjuvant) prior to clinical manifestations. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Appearance of “typical” clinical manifestations: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Myalgia, myositis or muscle weakness; \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arthralgia and/or arthritis; \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic fatigue, non-restorative sleep or sleep disorders; \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurological manifestations (especially those related to demyelination); \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cognitive abnormalities, memory loss; \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fever, dry mouth. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Removal of the triggering agent induces clinical improvement. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Typical biopsy of the affected organs. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Minor criteria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Appearance of autoantibodies or antibodies directed against the suspect adjuvant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other clinical manifestations (e.g., irritable bowel syndrome) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Specific HLA (HLA DRB1, HLA DQB1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Development of autoimmune disease \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2352775.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ASIA diagnostic criteria. Adapted from Shoenfeld & Agmon-Levin, 2011.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.S. Narins" 1 => "K. Beer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.prs.0000234919.25096.67" "Revista" => array:7 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2006" "volumen" => "118" "numero" => "Suppl." "paginaInicial" => "77S" "paginaFinal" => "84S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16936547" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "‘ASIA’ – autoimmune/inflammatory syndrome induced by adjuvants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Shoenfeld" 1 => "N. Agmon-Levin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Autoimm" "fecha" => "2011" "volumen" => "36" "paginaInicial" => "4" "paginaFinal" => "8" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) demonstrates distinct autoimmune and autoinflammatory disease associations according to the adjuvant subtype: Insights from an analysis of 500 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Watad" 1 => "N.L. Bragazzi" 2 => "D. McGonagle" 3 => "M. Adawi" 4 => "C. Bridgewood" 5 => "G. Damiani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clim.2019.03.007" "Revista" => array:6 [ "tituloSerie" => "Clin Immunol" "fecha" => "2019" "volumen" => "203" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30922961" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld's syndrome)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Vera-Lastra" 1 => "G. Medina" 2 => "P. Cruz-Dominguez Mdel" 3 => "P. Ramirez" 4 => "J.A. Gayosso-Rivera" 5 => "H. Anduaga-Dominguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0961203311429317" "Revista" => array:6 [ "tituloSerie" => "Lupus" "fecha" => "2012" "volumen" => "21" "paginaInicial" => "128" "paginaFinal" => "135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22235042" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoinflammatory/autoimmunity syndrome induced by adjuvants (ASIA; Shoenfeld's syndrome): a new flame" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.W. Cohen Tervaert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.autrev.2018.07.003" "Revista" => array:6 [ "tituloSerie" => "Autoimmun Rev" "fecha" => "2018" "volumen" => "17" "paginaInicial" => "1259" "paginaFinal" => "1264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30316995" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009500000004/v3_202008041755/S0365059620301367/v3_202008041755/en/main.assets" "Apartado" => array:4 [ "identificador" => "82769" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009500000004/v3_202008041755/S0365059620301367/v3_202008041755/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620301367?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 18 | 20 | 38 |
| 2024 October | 92 | 57 | 149 |
| 2024 September | 114 | 76 | 190 |
| 2024 August | 130 | 97 | 227 |
| 2024 July | 130 | 95 | 225 |
| 2024 June | 112 | 69 | 181 |
| 2024 May | 85 | 59 | 144 |
| 2024 April | 100 | 88 | 188 |
| 2024 March | 104 | 61 | 165 |
| 2024 February | 84 | 72 | 156 |
| 2024 January | 98 | 65 | 163 |
| 2023 December | 44 | 55 | 99 |
| 2023 November | 69 | 66 | 135 |
| 2023 October | 52 | 87 | 139 |
| 2023 September | 66 | 76 | 142 |
| 2023 August | 50 | 35 | 85 |
| 2023 July | 60 | 33 | 93 |
| 2023 June | 59 | 31 | 90 |
| 2023 May | 54 | 16 | 70 |
| 2023 April | 39 | 19 | 58 |
| 2023 March | 64 | 40 | 104 |
| 2023 February | 52 | 38 | 90 |
| 2023 January | 40 | 29 | 69 |
| 2022 December | 58 | 21 | 79 |
| 2022 November | 71 | 39 | 110 |
| 2022 October | 61 | 49 | 110 |
| 2022 September | 41 | 62 | 103 |
| 2022 August | 41 | 39 | 80 |
| 2022 July | 38 | 53 | 91 |
| 2022 June | 57 | 55 | 112 |
| 2022 May | 30 | 58 | 88 |
| 2022 April | 32 | 50 | 82 |
| 2022 March | 37 | 63 | 100 |
| 2022 February | 28 | 39 | 67 |
| 2022 January | 41 | 80 | 121 |
| 2021 December | 38 | 75 | 113 |
| 2021 November | 34 | 58 | 92 |
| 2021 October | 49 | 75 | 124 |
| 2021 September | 41 | 54 | 95 |
| 2021 August | 37 | 61 | 98 |
| 2021 July | 35 | 45 | 80 |
| 2021 June | 37 | 46 | 83 |
| 2021 May | 31 | 68 | 99 |
| 2021 April | 89 | 214 | 303 |
| 2021 March | 54 | 48 | 102 |
| 2021 February | 33 | 22 | 55 |
| 2021 January | 25 | 24 | 49 |
| 2020 December | 20 | 20 | 40 |
| 2020 November | 17 | 15 | 32 |
| 2020 October | 26 | 14 | 40 |
| 2020 September | 74 | 22 | 96 |
| 2020 August | 51 | 5 | 56 |
| 2020 July | 26 | 10 | 36 |
| 2020 June | 14 | 8 | 22 |
| 2020 May | 9 | 9 | 18 |
Show all
