Metallosis: A New Form of Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants Syndrome (ASIA)?
  • Rita Alexandra Vaz
    Department of Internal Medicine, Hospital São Francisco Xavier, Occidental Lisbon Hospital Centre, Portugal
  • Pedro Xavier
    Orthogeriatric Unit, Orthopedics and Traumatology Department, São Francisco Xavier Hospital, Occidental Lisbon Hospital Centre, Portugal
  • Sergio Brito
    Department of Internal Medicine, Hospital São Francisco Xavier, Occidental Lisbon Hospital Centre, Portugal
  • Jorge Dantas
    Department of Internal Medicine, Hospital São Francisco Xavier, Occidental Lisbon Hospital Centre, Portugal
  • Sofia Duque
    Orthogeriatric Unit, Internal Medicine Department, São Francisco Xavier Hospital, Occidental Lisbon Hospital Centre, Portugal
  • Jose Guimarães Consciência
    Orthogeriatric Unit, Orthopedics and Traumatology Department, São Francisco Xavier Hospital, Occidental Lisbon Hospital Centre, Portugal
  • Luis Campos
    Department of Internal Medicine, Hospital São Francisco Xavier, Occidental Lisbon Hospital Centre, Portugal

Keywords

ASIA syndrome, metallosis

Abstract

Autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) is a new entity in which exposure to an adjuvant triggers an aberrant autoimmune response. Metallosis is a rare condition characterized by the deposition and build-up of metal debris in the soft tissues of the body associated with metal-on-metal (MOM) prosthetic devices. It can present with local/systemic symptoms and signs due to a chronic inflammatory host response. The authors present the case of a 51-year-old woman with a 6-month history of systemic complaints due to intoxication with metal ions from hip metallosis. This case highlights the importance of follow-up and continuous monitoring of patients with a hip prosthesis. As this is a rare condition, a patient presenting with unspecific symptoms such as ASIA syndrome induced by metallosis requires a high level of clinical suspicion as the removal of the adjuvant can resolve the condition.

VIEW THE ENTIRE ARTICLE

References

  • Oliveira C, Candelária I, Oliveira P, Figueiredo A, Caseiro-Alves F. Metallosis: a diagnosis not only in patients with metal-on-metal prostheses. Eur J Radiol Open 2015;2:3–6.

  • Sink E. Postponing total hip arthoplasty: the role for capsular arthroplasty in developmental dysplasia of the hip. JBJS Orthopaedic Highlights: Hip Surgery 2012;2:e5.

  • Amanatullah D, Sucher M, Bonadurer G, Pereira G, Taunton M. Metal in total hip arthroplasty: wear particles, biology, and diagnosis. Orthopedics 2016;39:371–379.

  • Birkett N, El-Daly I, Ibraheim H, Mbubaegbu C. Metallosis following full thickness wear in total hip arthroplasty. J Surg Case Rep 2015;2015:rjv122.

  • Loyo E, Jara L, López P, Puig A. Autoimmunity in connection with a metal implant: a case of autoimmune/autoinflammatory syndrome induced by adjuvants.Auto Immun Highlights 2012;4:33–38.

    • Views: 1557
    HTML downloads: 1769
    PDF downloads: 682

    Published: 2019-02-25
    Issue: Vol 6 No 3 (view)

    How to cite:
    1.
    Vaz RA, Xavier P, Brito S, Dantas J, Duque S, Consciência JG, Campos L. Metallosis: A New Form of Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants Syndrome (ASIA)?. EJCRIM 2019;6 doi:10.12890/2019_001034.