Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants
Entity
UAM. Departamento de Anatomía Patológica; UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)Publisher
BioMed CentralDate
2016-01-08Citation
10.1186/s13000-016-0453-y
Diagnostic Pathology 11.2 (2016): 1-5
ISSN
1746-1596DOI
10.1186/s13000-016-0453-yFunded by
AO and CMC were supported by ISCIII and FEDER funds PI13/00047, REDinREN RD012/0021, Comunidad de Madrid CIFRA S2010/BMD-2378 and Programa Intensificación Actividad Investigadora. BFF by ISCIII Joan Rodes.Project
Gobierno de España. PI13/00047; Comunidad de Madrid. S2010/BMD-2378/CIFRAEditor's Version
http://dx.doi.org/10.1186/s13000-016-0453-ySubjects
C3 glomerulopathy; Esthetic filler implants; Nephritic syndrome; Polymethylmetacrylate; Post-infectious glomerulonephritis; MedicinaRights
© 2016 Cannata-Ortiz et alAbstract
Background: The systemic consequences of esthetic filler injections are poorly understood. Case presentation: We report a patient with a past history of subcutaneous injection of aesthetic filler material in the lower legs, who presented with post-infectious glomerulonephritis following necrotic leg ulcers at the injection site. Kidney biopsy revealed the presence of translucent, non-birefringent microspherical bodies compatible with polymethylmetacrylate (PMMA) microspheres in some capillary lumens. This had not previously been described. PMMA is a biphasic aesthetical filler composed of polymethylmetacrylate microspheres suspended in a biodegradable bovine collagen carrier. The solid phase (PMMA microspheres) persists in tissues for years. Although PMMA was thought to not disseminate systemically, tissue necrosis may have favored systemic dissemination of the microspheres, although entry in the circulation and microembolization at the time of administration cannot be ruled out. Conclusions: In conclusion, aesthetic filler implants may cause microembolization into small vessels. Recognition of the characteristic morphology may expedite diagnosis and avoid unnecessary further testing.
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Google Scholar:Cannata, Pablo
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Gracia, Carolina
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Aouad, Youssef
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Barat, Antonio
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Martinez-Gonzalez, Miguel Ángel
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Rossello, Gabriela
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Martin-Cleary, Catalina
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Fernández-Fernández, Beatriz
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Requena Caballero, Luis
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Ortiz Arduán, Alberto
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