Severe Complications Due to Biopolymers in a Patient With Autoimmune Disease: A Case Report and Review of the Literature.

Abstract

Biopolymers are frequently used for aesthetic or reconstructive purposes, often without adequate consideration of the potential long-term health complications they may cause. The use of these substances has been associated with autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA syndrome); however, the existing literature is limited, and there is currently no clear consensus regarding its management. This case report aims to describe a case of severe biopolymer-induced inflammatory disease in a patient with a diagnosis of rheumatoid arthritis, highlighting both the diagnostic and therapeutic approaches. This case report examines a 58-year-old female patient with a history of biopolymer application to the gluteal and facial region 20 years before and a diagnosis of rheumatoid arthritis for the past 2 years. She presented with severe inflammatory skin lesions with worsening arthralgia. An MRI scan revealed exogenous material with signs of severe inflammation of the surrounding tissues, and a biopsy was consistent with foreign body granulomas with a "Swiss cheese" morphology. The patient was hospitalized and received multidisciplinary management, achieving an excellent clinical response. This case highlights the importance of a comprehensive evaluation and a multidisciplinary approach in patients with autoimmune disease and previous exposure to biopolymers. The coexistence of autoimmune diseases can aggravate the inflammatory response, suggesting the need for additional studies exploring this interaction and its prognostic impact. Level of Evidence: 5 (Risk).