Abstract
In this manuscript, we report an exceptional observation study of a young woman suffering from an autoimmune syndrome induced by adjuvants (ASIA). Until today only seven cases of adult-onset Still’s disease (AOSD) induced by breast implants have been published. This may be due to the fact that this illness itself is very rare; however, the reason might also be that the community is not sensitized to the case-specific symptoms. Within this article, we show for the first time highly detailed diagnostic test procedures such as PET-CT scans and specific histological staining of the breast tissue, displaying proinflammatory macrophages that are a well-known activator and booster of autoimmune diseases. We hope to give new insights into the clinical picture and pathogenesis of AOSD in order to improve the challenging diagnosis.
Zusammenfassung
In der vorliegenden Arbeit wird eine außergewöhnliche Beobachtungsstudie an einer jungen Frau dargestellt, welche an einem durch Adjuvanzien induzierten Autoimmunsyndrom („autoimmune syndrome induced by adjuvants“, ASIA) litt. Bisher wurden nur 7 Fälle eines Adult-Onset-Still-Syndroms (AOSD) beschrieben, die durch Brustimplantate induziert wurden. Das mag daran liegen, dass diese Erkrankung an sich sehr selten ist, jedoch auch daran, dass die Allgemeinheit nicht für die fallspezifischen Symptome sensibilisiert ist. Im vorliegenden Beitrag werden erstmals sehr genaue diagnostische Testverfahren wie die Untersuchung mittels PET-CT (Positronenemissionstomographie-Computertomographie) und eine spezifische histologische Färbung des Brustgewebes dargestellt, mit denen proinflammatorische Makrophagen nachgewiesen wurden, die bekanntlich Aktivator und Verstärker von Autoimmunerkrankungen sind. Die Autoren hoffen, auf diese Weise neue Einsichten in das klinische Bild und die Pathogenese des AOSD zu geben, um damit den Umgang mit dieser diagnostischen Herausforderung zu verbessern.
References
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Contributors
All authors managed the patient. AW, GG, JJ, CT, and KS wrote the report. Written consent for publication was obtained.
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None of the authors received funding for writing the manuscript.
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A. Wehr, G. Grieb, C. Trautwein, and K. Streetz declare that they have no competing interests.
This article does not contain any studies with human participants or animals performed by any of the authors. Consent was obtained from all patients identifiable from images or other information within the manuscript. In the case of underage patients, consent was obtained from a parent or legal guardian.
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E. Reinhold-Keller, Hamburg
F. Moosig, Neumünster
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Wehr, A., Grieb, G., Trautwein, C. et al. Unusual onset of adult still’s disease due to a systemic reaction to artificial breast implants. Z Rheumatol 76, 547–549 (2017). https://doi.org/10.1007/s00393-017-0277-5
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DOI: https://doi.org/10.1007/s00393-017-0277-5