Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome) – An update

Lupus ◽  
2017 ◽  
Vol 26 (7) ◽  
pp. 675-681 ◽  
Author(s):  
A Watad ◽  
M Quaresma ◽  
S Brown ◽  
J W Cohen Tervaert ◽  
I Rodríguez-Pint ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Silicone Implants ◽  
Systemic Lupus ◽  
Endogenous Factors ◽  
Immune Mediated ◽  
Autoimmune Conditions ◽  
Asia Syndrome ◽  
Inflammatory Syndrome ◽  
The Relationship

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants. In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).

scholarly journals AUTOIMMUNE/INFLAMMATORYSYNDROMEINDUCEDBYADJUVANTS (ASIA) - REVISION

2021 ◽  
Vol 9 (5) ◽  
pp. 798-804
Author(s):  
Adriana Novaes Rodrigues
Keyword(s):  
Current Knowledge ◽  
Clinical Manifestations ◽  
Adjuvant Activity ◽  
Autoantibody Production ◽  
Disease Spectrum ◽  
Autoimmune Conditions ◽  
Asia Syndrome ◽  
Specific Symptoms ◽  
Inflammatory Syndrome ◽  
The Relationship

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA), also known as Shoenfeld’s syndrome, encompasses several autoimmune conditions andphenomena that are induced following the exposure to substances with adjuvant activity. The disease spectrum is heterogeneous in respect to clinical presentation as well as severity of the clinical manifestations. Some genetically predisposed individuals can develop generalized non-specific symptoms, autoantibody production, new onset, or worsening of disease presentation. In this review, we focus on the current knowledge presented in the literature on ASIA syndrome, increasing awareness about the basic concepts and highlight the amount of data accumulated in the last few years concerning the relationship between various adjuvants and autoimmunity.

scholarly journals Dual threat of comorbidity of celiac disease and systemic lupus erythematosus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Yimin Ma ◽  
Duanming Zhuang ◽  
Zhenguo Qiao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Celiac Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Severe Malnutrition ◽  
Systemic Lupus ◽  
Electrolyte Disorders ◽  
Diagnostic Challenge ◽  
Immune Mediated

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.

SYSTEMIC LUPUS ERYTHEMATOSUS AND SYNDROMES POSSIBLY RELATED

PEDIATRICS ◽  
1957 ◽  
Vol 19 (6) ◽  
pp. 1109-1123
Author(s):  
M. A. Ogryzlo ◽  
H. A. Smythe
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Serum Proteins ◽  
Clinical Manifestations ◽  
Electrophoretic Pattern ◽  
Chemotherapeutic Agents ◽  
Systemic Lupus ◽  
Relationship Of ◽  
The Relationship

Attention is drawn to the difficulties that may be encountered in the positive identification and classification of many patients suspected of suffering from systemic lupus erythematosus. Much of this is due to a lack of specific criteria, either clinical or pathologic, for the diagnosis of the disease. The problem has been made more difficult by the recognition of a number of other syndromes that bear a superficial resemblance to systemic lupus erythematosus, yet differ in clinical manifestations, natural course, prognosis and other respects. A feature common to the group is the presence of the L.E. cell phenomenon. The related conditions differ from lupus enythematosus in that the L.E. phenomenon may only be demonstrable intermittently especially during severe exacerbations of the disease, while at the same time disturbances in the electrophoretic pattern of the serum proteins may be much more profound. In systemic rheumatoid disease the prognosis without steroid therapy is better than in systemic lupus erythematosus, although the morbidity may be great. The reactions which follow administration of certain chemotherapeutic agents are of considerable interest, particularly in view of the similarity to lupus erythematosus and rheumatoid arthritis, and the reversibility on withdrawal of the offending agent. The relationship of these syndromes to each other and to classical systemic lupus erythematosus has not yet been resolved, and inclusion of them under the diagnosis of systemic lupus erythematosus at this time must be regarded as premature.

Neuromyelitis optica spectrum disorder and systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1722-1726 ◽  
Author(s):  
M M Thabah ◽  
Sekar D ◽  
R Pranov ◽  
M M V Moulitej ◽  
A Ramesh ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Neuromyelitis Optica ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Systemic Lupus ◽  
Autoimmune Conditions ◽  
Inflammatory Syndrome ◽  
Extensive Transverse Myelitis

Neuromyelitis optica spectrum disorder is an inflammatory syndrome that is associated with many autoimmune conditions. We present the case of a patient who had longitudinally extensive transverse myelitis and antibodies to aquaporin 4 IgG (AQP4-IgG). Based on presence of lymphopenia, further workup revealed strong ANA positivity, anti-Sm antibodies, and low serum complements suggesting presence of systemic lupus erythematosus. The patient promptly responded to intravenous pulse methylprednisolone and five sessions of plasma exchange. At 1 year, she is on maintenance treatment with low dose prednisolone, azathioprine, and hydroxychloroquine, she has had no relapse and no other clinical features of lupus. This case is an illustration that neuromyelitis optica spectrum disorder can be the first manifestation of systemic lupus erythematosus.

scholarly journals The relationship of systemic vascular lesions to clinical manifestations in systemic lupus erythematosus

Ensho ◽  
1983 ◽  
Vol 3 (2) ◽  
pp. 144-150
Author(s):  
Hiroshi Hashimoto ◽  
Soichiro Maekawa ◽  
Hajime Nasu ◽  
Takao Okada ◽  
Yuichi Shiokawa ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Vascular Lesions ◽  
Systemic Lupus ◽  
Relationship Of ◽  
The Relationship

scholarly journals Classical Examples of the Concept of the ASIA Syndrome

Biomolecules ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1436
Author(s):  
Vânia Borba ◽  
Anna Malkova ◽  
Natalia Basantsova ◽  
Gilad Halpert ◽  
Laura Andreoli ◽  
...  
Keyword(s):  
Immune System ◽  
Clinical Manifestations ◽  
Breast Implants ◽  
Undifferentiated Connective Tissue Disease ◽  
Ptpn22 Gene ◽  
Silicone Breast Implants ◽  
Immune Mediated ◽  
Asia Syndrome ◽  
Skin Biopsies ◽  
Inflammatory Syndrome

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 by Shoenfeld et al. and encompasses a cluster of related immune mediated diseases, which develop among genetically prone individuals as a result of adjuvant agent exposure. Since the recognition of ASIA syndrome, more than 4400 documented cases have been reported so far, illustrated by heterogeneous clinical manifestations and severity. In this review, five enigmatic conditions, including sarcoidosis, Sjögren’s syndrome, undifferentiated connective tissue disease, silicone implant incompatibility syndrome (SIIS), and immune-related adverse events (irAEs), are defined as classical examples of ASIA. Certainly, these disorders have been described after an adjuvant stimulus (silicone implantation, drugs, infections, metals, vaccines, etc.) among genetically predisposed individuals (mainly the HLA-DRB1 and PTPN22 gene), which induce an hyperstimulation of the immune system resulting in the production of autoantibodies, eventually leading to the development of autoimmune diseases. Circulating autonomic autoantibodies in the sera of patients with silicone breast implants, as well as anatomopathological aspects of small fiber neuropathy in their skin biopsies have been recently described. To our knowledge, these novel insights serve as a common explanation to the non-specific clinical manifestations reported in patients with ASIA, leading to the redefinition of the ASIA syndrome diagnostic criteria.

scholarly journals Interleukin-21: A New Mediator of Inflammation in Systemic Lupus Erythematosus

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Massimiliano Sarra ◽  
Giovanni Monteleone
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Autoimmune Disorder ◽  
T And B Cells ◽  
Systemic Lupus ◽  
Immune Mediated ◽  
Wide Range ◽  
Interleukin 21 ◽  
And Function

Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterized by excessive production of a variety of autoantibodies and a wide range of clinical manifestations. Pathogenesis of SLE is complex and not fully understood. There is however evidence that B and T cells are critical to the development of disease, and that T cell-derived cytokines are involved in the SLE-associated inflammatory response. One such cytokine seems to be interleukin (IL)-21, the latest identified member of the -chain-related cytokine family. IL-21 has an important role in the control of the growth, survival, differentiation, and function of both T and B cells, and excessive production of IL-21 has been associated with the development of multiple immune-mediated diseases. Here we review data supporting the involvement of IL-21 in the pathogenesis of SLE.

scholarly journals The Relationship between Neutrophil Lymphocyte Ratio with Disease Activity in Systemic Lupus Erythematosus

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Gede Kambayana ◽  
I Gusti Agung Friskha Surya Putra ◽  
Pande Ketut Kurniari ◽  
Tjokorda Raka Putra
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Background. Systemic Lupus Erythematosus (SLE) is an Autoimmune inflammatory disease that is systemic and chronic inflammation with heterogeneous of history, clinical manifestations, and prognosis. The disease activity of SLE has been proven as a predictor of organ damage and death by evidenced of inflammatory markers involved in this disease. Neutrophil to Lymphocyte Ratio (NLR) is useful for estimating the activity of autoimmune disease and inflammation that easily obtained from blood test and low cost and measurable as new biomarker to assess inflammatory response or activity of SLE. This study aimed to determine the relationship between NRL and Disease Activity based on Mex-SLEDAI in patients SLE. Methods. This study is an analytic study with cross sectional design. It started from November 2016 until March 2017. Mex-SLEDAI and blood sampling used in this study. Result. Total sample in this study is 54 patients with median age was 28.5 years, with mostly female (85,2%). Result analysis with positive correlation between NLR with disease activity on SLE (r=0.399  p=0.003  n=54), thus the Scatter plot shows there is a correlation between NRL with Mex-SLEDAI. Conclusion. Positive correlation between NLR and disease activity of the SLE, the higher of the disease activity/Mex-SLEDAI will be followed by the increase of NLR.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

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