Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)

Aim. To report a clinical case of autoimmune/inflammatory syndrome, induced by adjuvants in patient after polypropylene mesh implantation for inguinal hernia repair.Materials and methods. Patient Z., male, 68 years old, was admitted to the hospital presenting muscle weakness and progressive dyspnoea...

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Main Authors: V. Yu. Matveev, O. V. Trushina, D. Yu. Shchekochikhin, N. M. Babadaeva, E. V. Gracheva, A. S. Shilova, A. P. Nesterov
Format: Article
Language:Russian
Published: ABV-press 2024-06-01
Series:Klinicist
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Online Access:https://klinitsist.abvpress.ru/Klin/article/view/592
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author V. Yu. Matveev
O. V. Trushina
D. Yu. Shchekochikhin
N. M. Babadaeva
E. V. Gracheva
A. S. Shilova
A. P. Nesterov
author_facet V. Yu. Matveev
O. V. Trushina
D. Yu. Shchekochikhin
N. M. Babadaeva
E. V. Gracheva
A. S. Shilova
A. P. Nesterov
author_sort V. Yu. Matveev
collection DOAJ
description Aim. To report a clinical case of autoimmune/inflammatory syndrome, induced by adjuvants in patient after polypropylene mesh implantation for inguinal hernia repair.Materials and methods. Patient Z., male, 68 years old, was admitted to the hospital presenting muscle weakness and progressive dyspnoea. Interview and physical exam revealed signs of cognitive impairment and memory loss, proximal muscle weakness. Differential diagnosis was made to clarify genesis of symptoms, to rule out polymyositis, other systemic connective tissue diseases, oncologic diseases, hypothyroidism, infectious diseases.Results. Creatine kinase, thyroxine, thyreothropic hormone levels were normal. Clinical and immunological investigation revealed no data on polymyositis or any other systemic connective tissue disease. Yersiniosis, salmonellosis, malaria were ruled out. Chest CT scan, abdomen CT scan, gastroscopy, colonoscopy no data on the presence of malignant neoplasms. PSA level were normal. Electroneuromyography revealed signs of symmetrical axonal type damage to the motor portion of the ulnar nerves on both sides, and demyelinating type damage to the sensory portion. Prednisolone therapy was started at a dose of 40 mg per 24 hour (0.5 mg per kg), which lead to a significant clinical improvement. Based on the therapy response and positive diagnostic criteria (clinical manifestation after polypropylene mesh implantation, typical clinical manifestation – muscle weakness, chronic fatigue, cognitive impairment, neurological manifestations associated with demyelination) patient was diagnosed with autoimmune/inflammatory syndrome, induced by adjuvants (ASIA) after polypropylene mesh implantation for inguinal hernia repair.Conclusion. This clinical case report demonstrates possibility of a persistent course of the disease (symptoms were present for 15 years). Feature of this case is partial clinical improvement due to long-term uncontrolled dexamethasone use, which was prescribed empirically.
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spelling doaj-art-425b4315614c403381d27f5c3ad102b82025-08-20T04:00:43ZrusABV-pressKlinicist1818-83382024-06-01181707710.17650/1818-8338-2024-18-1-K685428Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)V. Yu. Matveev0O. V. Trushina1D. Yu. Shchekochikhin2N. M. Babadaeva3E. V. Gracheva4A. S. Shilova5A. P. Nesterov6N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaN.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare DepartmentN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare DepartmentN.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare DepartmentN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare DepartmentN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare DepartmentAim. To report a clinical case of autoimmune/inflammatory syndrome, induced by adjuvants in patient after polypropylene mesh implantation for inguinal hernia repair.Materials and methods. Patient Z., male, 68 years old, was admitted to the hospital presenting muscle weakness and progressive dyspnoea. Interview and physical exam revealed signs of cognitive impairment and memory loss, proximal muscle weakness. Differential diagnosis was made to clarify genesis of symptoms, to rule out polymyositis, other systemic connective tissue diseases, oncologic diseases, hypothyroidism, infectious diseases.Results. Creatine kinase, thyroxine, thyreothropic hormone levels were normal. Clinical and immunological investigation revealed no data on polymyositis or any other systemic connective tissue disease. Yersiniosis, salmonellosis, malaria were ruled out. Chest CT scan, abdomen CT scan, gastroscopy, colonoscopy no data on the presence of malignant neoplasms. PSA level were normal. Electroneuromyography revealed signs of symmetrical axonal type damage to the motor portion of the ulnar nerves on both sides, and demyelinating type damage to the sensory portion. Prednisolone therapy was started at a dose of 40 mg per 24 hour (0.5 mg per kg), which lead to a significant clinical improvement. Based on the therapy response and positive diagnostic criteria (clinical manifestation after polypropylene mesh implantation, typical clinical manifestation – muscle weakness, chronic fatigue, cognitive impairment, neurological manifestations associated with demyelination) patient was diagnosed with autoimmune/inflammatory syndrome, induced by adjuvants (ASIA) after polypropylene mesh implantation for inguinal hernia repair.Conclusion. This clinical case report demonstrates possibility of a persistent course of the disease (symptoms were present for 15 years). Feature of this case is partial clinical improvement due to long-term uncontrolled dexamethasone use, which was prescribed empirically.https://klinitsist.abvpress.ru/Klin/article/view/592autoimmune/inflammatory syndrome, induced by adjuvantsshoenfeld’s syndromepolypropylenepolypropylene meshinguinal herniaherniaadjuvantmuscle weaknesschronic fatiguedemyelinationcognitive impairment
spellingShingle V. Yu. Matveev
O. V. Trushina
D. Yu. Shchekochikhin
N. M. Babadaeva
E. V. Gracheva
A. S. Shilova
A. P. Nesterov
Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
Klinicist
autoimmune/inflammatory syndrome, induced by adjuvants
shoenfeld’s syndrome
polypropylene
polypropylene mesh
inguinal hernia
hernia
adjuvant
muscle weakness
chronic fatigue
demyelination
cognitive impairment
title Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
title_full Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
title_fullStr Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
title_full_unstemmed Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
title_short Autoimmune/inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair (clinical case)
title_sort autoimmune inflammatory syndrome induced by adjuvants in a patient after implantation of a polypropylene mesh for inguinal hernia repair clinical case
topic autoimmune/inflammatory syndrome, induced by adjuvants
shoenfeld’s syndrome
polypropylene
polypropylene mesh
inguinal hernia
hernia
adjuvant
muscle weakness
chronic fatigue
demyelination
cognitive impairment
url https://klinitsist.abvpress.ru/Klin/article/view/592
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