Key result
Prosthesis explantation in a 45-year-old woman with ASIA syndrome resulted in the resolution of her intense refractory headache and systemic symptoms.
Why the study?
Headache is typical in ASIA, but literature lacks information regarding its characteristics and pathophysiology.
Does prosthesis explantation resolve symptoms in a patient with ASIA syndrome presenting with refractory headache?
Case Report (n=1)
Does prosthesis explantation resolve symptoms in a patient with ASIA syndrome presenting with refractory headache?
Prosthesis explantation resolved refractory headache and systemic symptoms in a patient with ASIA syndrome, highlighting the need to consider adjuvant-induced autoimmunity in unexplained chronic headaches.
Headache may predominate in silicone-induced ASIA; case reports leave open systematic characterization of its features.
Background Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses a set of immune rare diseases triggered by adjuvants, like silicone. Although headache is typical in these cases, the literature lacks information about its characteristics and pathophysiology in ASIA. Objective Describe and discuss a case of ASIA with headache as the main symptom, approaching its immunopathological and clinical aspects. Case A 45-year-old woman with silicone prosthesis presented an intense headache, accompanied by chronic fatigue, sleep and skin disturbances, paresthesia, and generalized body aches. She had sought medical care over the past 2 years, with no underlying identified until then. The fulfillment of ASIA diagnostic criteria and subsequent prosthesis explantation resulted in symptom resolution. Conclusion Additional research is required to understand the semiotic patterns linked to ASIA syndrome-induced headaches. A dysregulation in histaminergic GPCR and GRK levels is hypothesized by the authors to be involved in the main mechanisms responsible for leading the headache nociceptive storm induced in ASIA.
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Makita et al. (2024) conducted a case report in Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) (n=1). Prosthesis explantation was evaluated on Symptom resolution. Prosthesis explantation in a 45-year-old woman with ASIA syndrome resulted in the resolution of her intense refractory headache and systemic symptoms.
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