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)

Tumor de células gigantes óseo en arco costal, tratado con denosumab. Reporte de un caso / Giant cell tumour of bone in the rib cage treated with denosumab. A case report

El tumor de células gigantes óseo (TCGO) representa el 4-5% de los tumores óseos primarios, se localiza en la epífisis de huesos largos, cuerpos vertebrales y huesos planos, y es más frecuente en el sexo femenino entre los 20 y 45 años. Presentamos el caso de una mujer de 31 años con dolor torácico de un mes de evolución. En la exploración física se palpó un nódulo en mama derecha y semiología de derrame pleural ipsilateral. El estudio mediante TAC torácica evidenció una masa infiltrante. La lesión fue biopsiada, permitiendo el diagnóstico de TCGO. Debido a la localización y a la morfología, se planteó un amplio diagnóstico diferencial. Adicionalmente, se detectó la mutación del gen de la histona H3F3A, reforzando el diagnóstico. Recibió tratamiento neoadyuvante con denosumab, haciendo posible la posterior resección quirúrgica de la lesión. En la pieza quirúrgica se observaron cambios histológicos, fuente de pitfalls diagnósticos.(AU)

Giant cell tumour of bone (GCTOB) accounts for 4-5% of all primary bone tumours and occurs most frequently in females between 20 and 45 years old. It is found in the epiphyses of the long bones, vertebral bodies and flat bones.We report the case of a 31-year-old woman who presented with a one month history of thoracic pain. On examination, a mass was found in the right breast with signs of an ipsilateral pleural effusion. A thoracic CAT scan revealed an infiltrating mass which was subsequently biopsied and a GCTOB was diagnosed. Due to the localization and the morphology, a wide range of differential diagnoses were considered. Genetic studies detected a mutation of the gene H3F3A, supporting the original diagnosis. The patient underwent treatment with denosumab followed by surgical resection of the mass. The histopathology of the tumour revealed various histological changes which were a source of diagnostic pitfalls.(AU)

[Giant cell tumour of bone in the rib cage treated with denosumab. A case report]. / Tumor de células gigantes óseo en arco costal, tratado con denosumab. Reporte de un caso.

Giant cell tumour of bone (GCTOB) accounts for 4-5% of all primary bone tumours and occurs most frequently in females between 20 and 45 years old. It is found in the epiphyses of the long bones, vertebral bodies and flat bones. We report the case of a 31-year-old woman who presented with a one month history of thoracic pain. On examination, a mass was found in the right breast with signs of an ipsilateral pleural effusion. A thoracic CAT scan revealed an infiltrating mass which was subsequently biopsied and a GCTOB was diagnosed. Due to the localization and the morphology, a wide range of differential diagnoses were considered. Genetic studies detected a mutation of the gene H3F3A, supporting the original diagnosis. The patient underwent treatment with denosumab followed by surgical resection of the mass. The histopathology of the tumour revealed various histological changes which were a source of diagnostic pitfalls.