Immunologic Research

, Volume 65, Issue 1, pp 8–16

Severe manifestations of autoimmune syndrome induced by adjuvants (Shoenfeld’s syndrome)

  • Luis J. Jara
  • Grettel García-Collinot
  • Gabriela Medina
  • Maria del Pilar Cruz-Dominguez
  • Olga Vera-Lastra
  • Rosa A. Carranza-Muleiro
  • Miguel A. Saavedra
Environment and Autoimmunity

Abstract

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompassing conditions linked to previous exposure to an adjuvant substance. The clinical picture is very heterogeneous, from mild to severe manifestations, including death. However, the systematic analysis of severe ASIA cases has not been performed. The aim of this study was to systematically review the literature on severe ASIA cases. A systematic review of the literature was performed investigating severe ASIA cases. All publications were identified through PubMed, EMBASE, MEDLINE and Cochrane. Articles published from 2011 to 2016 were included. Severe ASIA was arbitrarily defined as follows: major organ involvement, life-threatening conditions, intensive treatment, disability, hospitalization and outcome (survival and death). Cases described before 2011 were excluded. From 2011 to 2016, we identified 4479 ASIA cases, of them 305 fulfilled arbitrary criteria of severe ASIA including our case presentation and 11 deaths. The majority of severe ASIA cases were related to HPV vaccine, silicone, influenza vaccine and mineral oil injections. The interval from exposition to severe manifestation was from 2 days to 23 years. (1) This is the first study that analyzes all cases published on ASIA with severe manifestations. (2) The current HPV vaccine is both effective and generally safe. However, it should be noted that severe autoimmune side effects have been reported in several studies. Severe ASIA may be observed after influenza vaccines, and other vaccines. (3) Efforts should be made to discover the connection between adjuvants, autoimmunity and autoimmune diseases, because there is an increase in cases severe and life-threatening of ASIA.

Keywords

Autoimmune syndrome induced by adjuvants Severe ASIA HPV vaccines Silicone breast implants Mineral oil injection 

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Luis J. Jara
    • 1
    • 6
  • Grettel García-Collinot
    • 2
  • Gabriela Medina
    • 3
    • 6
  • Maria del Pilar Cruz-Dominguez
    • 2
    • 6
  • Olga Vera-Lastra
    • 4
    • 6
  • Rosa A. Carranza-Muleiro
    • 2
  • Miguel A. Saavedra
    • 5
    • 6
  1. 1.Direction of Education and ResearchHospital de Especialidades Centro Médico Nacional La Raza, IMSSMexico CityMexico
  2. 2.Research DivisionHospital de Especialidades Centro Médico Nacional La Raza, IMSSMexico CityMexico
  3. 3.Clinical Research UnitHospital de Especialidades Centro Médico Nacional La Raza, IMSSMexico CityMexico
  4. 4.Internal Medicine DepartmentHospital de Especialidades Centro Médico Nacional La Raza, IMSSMexico CityMexico
  5. 5.Rheumatology DepartmentHospital de Especialidades Centro Médico Nacional La Raza, IMSSMexico CityMexico
  6. 6.Universidad Nacional Autónoma de MéxicoMexico CityMexico

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