AUTOINFLAMMATORY/AUTOIMMUNITY SYNDROME INDUCED BY ADJUVANTS (SHOENFELD’S SYNDROME) DUE TO HYSTEROSCOPIC ESSURE STERILIZATION
- Jan Willem Cohen Tervaert, Canada
Abstract
Background and Aims
Autoinflammatory/autoimmunity Syndrome induced by Adjuvants (ASIA) can be induced by implantation of foreign bodies such as vaginal mesh and silicone breast implants. Sterilization using the Essure device has been associated with various safety issues. The aim of the present study was to determine whether these patients may suffer from a foreign-body type of ASIA.
Methods
A case report is presented. In addition, patient files of 34 consecutive patients who underwent surgical removal of their Essure device were studied for symptoms compatible with ASIA
Results
A 38 year old female patient known for 10 years with Granulomatosis and Polyangiitis developed symptoms compatible with ASIA (severe fatigue, myalgias, arthralgias, cognitive impairment and irritable bowel syndrome (IBS)) after Essure sterilization in 2014. Directly after removal of the device (July 2016), all complaints disappeared. Out of 34 evaluated patients that underwent Essure removal in Yorkville, IL, USA, because of pelvic pain, 14 of 34 patients spontaneously reported prior to Essure removal severe fatigue, 21 of 34 reported myalgias/arthralgias, and 11 of 34 reported cognitive impairment. In addition, after Essure placement 17 of 34 developed IBS, 10 of 34 developed hair loss, whereas 2 patients had a new diagnosis of inflammatory bowel disease. Post-operative recovery was good with disappearance of nearly all symptoms.
Conclusions
Essure device implementation may cause symptoms as has been found in other forms of foreign body induced ASIA. We postulate that Polyethylene Teraphalate (PET) fibers and Nickel/Titanium alloy coil (both present in the Essure device) may be responsible for this effect.