The "autoimmune/inflammatory syndrome induced by adjuvants" (ASIA) after COVID-19 infection: A case report.

The term "autoimmune/inflammatory syndrome induced by adjuvants" (ASIA) describes a variety of autoimmune conditions triggered by exposure to substances with adjuvant activity. We present the case of a patient with a history of biopolymer infiltration in both glutes, who years later experienced progressive weakness and pain in the lower limbs, myalgias, cramps, and progressive functional impotence following a mild COVID-19 infection. Laboratory test results were not consistent with any autoimmune disease. Physical examination revealed diffuse bilateral subcutaneous nodules. After an extensive etiological study, a gluteal biopsy was performed, which showed findings compatible with sclerosing lipogranuloma. Our patient required treatment with high-dose glucocorticoids and showed significant improvement in symptoms during long-term follow-up. We suggest the role of COVID-19 infection as a possible trigger for ASIA, as it has already been described as a trigger for several other autoimmune diseases.

The “autoimmune/inflammatory syndrome induced by adjuvants” (ASIA) after COVID-19 infection: A case report / «Síndrome autoinmune/inflamatorio inducido por adyuvantes» (ASIA) tras infección por COVID-19: a propósito de un caso

The term “autoimmune/inflammatory syndrome induced by adjuvants” (ASIA) describes a variety of autoimmune conditions triggered by exposure to substances with adjuvant activity. We present the case of a patient with a history of biopolymer infiltration in both glutes, who years later experienced progressive weakness and pain in the lower limbs, myalgias, cramps, and progressive functional impotence following a mild COVID-19 infection. Laboratory test results were not consistent with any autoimmune disease. Physical examination revealed diffuse bilateral subcutaneous nodules. After an extensive etiological study, a gluteal biopsy was performed, which showed findings compatible with sclerosing lipogranuloma. Our patient required treatment with high-dose glucocorticoids and showed significant improvement in symptoms during long-term follow-up. We suggest the role of COVID-19 infection as a possible trigger for ASIA, as it has already been described as a trigger for several other autoimmune diseases.(AU)

El término «síndrome autoinmune/inflamatorio inducido por adyuvantes» (ASIA) describe una variedad de condiciones autoinmunes desencadenadas por la exposición a sustancias con actividad adyuvante. Presentamos el caso de una paciente con antecedentes de infiltración de biopolímeros en ambos glúteos que años más tarde experimentó debilidad progresiva y dolor en extremidades inferiores, mialgias, calambres e impotencia funcional progresiva después de una infección leve por COVID-19. Los resultados de los análisis de laboratorio no sugerían enfermedad autoinmune. El examen físico reveló nódulos subcutáneos difusos bilaterales. Después de un extenso estudio etiológico, se realizó una biopsia glútea, la cual mostró hallazgos compatibles con lipogranuloma esclerosante. La paciente requirió tratamiento con glucocorticoides a dosis altas y mostró una mejora significativa en los síntomas durante el seguimiento a largo plazo. Sugerimos el papel de la infección por COVID-19 como posible desencadenante de ASIA, ya que se ha descrito como desencadenante de otras enfermedades autoinmunes.(AU)