Metallosis: A New Form of Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants Syndrome (ASIA)?

Authors

• 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

RITAALEXVAZ@GMAIL.COM

Keywords

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.