Clinical and Immunological Characteristics of Patients with Biopolymers and Autoimmune Inflammatory Syndrome Induced by Adjuvants

Jaime Eduardo Pachón S; Marcela C Salazar; Adriana M Pores; Victor Z Rizo

doi:10.1097/GOX.0000000000003796

Clinical and Immunological Characteristics of Patients with Biopolymers and Autoimmune Inflammatory Syndrome Induced by Adjuvants

Plast Reconstr Surg Glob Open. 2021 Sep 24;9(9):e3796. doi: 10.1097/GOX.0000000000003796. eCollection 2021 Sep.

Authors

Jaime Eduardo Pachón S¹, Marcela C Salazar², Adriana M Pores³, Victor Z Rizo⁴

Affiliations

¹ Plastic and Reconstructive Surgery, Microsurgery Centro Medico Almirante Colon, Bogotá, Colombia.
² Physician Private Practice, Bogotá, Colombia.
³ Occupational Medicine, Private Practice, Bogotá, Colombia.
⁴ Epidemiologist, Private Practice, Bogotá, Colombia.

Abstract

Biopolymers consist of non-biocompatible allogeneic materials. They have been associated with autoimmune inflammatory syndrome induced by adjuvants, as described by Yehuda Shoenfeld and Nancy Agmon-Levin. Therefore, this study aimed to evaluate the clinical and immunological characteristics of patients with autoimmune inflammatory syndrome induced by adjuvants treated at a plastic surgery clinic in Colombia.

Methods: This cross-sectional, descriptive observational study included 190 patients with biopolymers in the buttocks with no evidence of autoimmune disease who were diagnosed with autoimmune inflammatory syndrome induced by adjuvants and underwent treatment at a private plastic surgery clinic from 2017 to 2020. The clinical and paraclinical parameters were measured preoperatively, when the diagnosis of autoimmune inflammatory syndrome induced by adjuvants and the need for material removal were established, and postoperatively after 3 months.

Results: The most frequent symptoms were myalgia (92%), arthralgia (77.9%), asthenia (77.9%), adynamia (77.9%), and neurological symptoms (55.8%). Preoperatively, patients were positive for antinuclear antibody, lactate dehydrogenase, complement proteins C3 and C4, and lupus anticoagulant. However, after removal of the biopolymer, there was a decrease in positivity or conversion to a negative status of paraclinical tests. Moreover, there was an association between LDH positivity and disease severity (odds ratio: 4.1, 95% confidence interval: 1.94-8.92).

Conclusions: The removal of biopolymers using an open surgical technique in symptomatic or asymptomatic patients is crucial for functional and reconstructive purposes and to improve the quality of life. Therefore, this condition should be known as "human adjuvant disease caused by biopolymers." Further, this condition mimics autoimmune diseases, with clinical and paraclinical manifestations that improve biopolymer removal.