Síndrome de Embolia por silicona: Una revisión de tema
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abr 13, 2022
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Lina María Ávila Arenas
https://orcid.org/0000-0001-7947-0379
María Piedad Londoño Duarte
https://orcid.org/0000-0002-2314-765X
German Danilo Ojeda Toro
https://orcid.org/0000-0001-9040-5826
https://orcid.org/0000-0001-7947-0379
María Piedad Londoño Duarte
https://orcid.org/0000-0002-2314-765X
German Danilo Ojeda Toro
https://orcid.org/0000-0001-9040-5826
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Resumen
Desde su descubrimiento la silicona ha tenido amplios y diversos usos, tal es el caso de la silicona de uso médico (polidimetilsiloxano) que se ha empleado con diferentes propósitos como implantes valvulares, articulares, procedimientos oculares, procedimientos cosméticos y reconstructivos, sin embargo, su utilización se ha extendido fuera del campo médico profesional, con la realización de procedimientos estéticos clandestinos favoreciendo la aparición de complicaciones (14), como el desplazamiento o migración de la silicona desde el sitio inyectado, inflamación de la piel en el sitio de inyección, lipodistrofia, granulomas nodulares, lesiones quísticas, ulceraciones, cicatrices desfigurantes, problemas respiratorios y embolia sistémica de silicona, siendo este último potencialmente fatal sin diagnóstico ni tratamiento oportuno (6). Esta entidad es una complicación grave que se presenta posterior a la administración de la silicona a nivel del tejido subcutáneo, en donde factores como la pureza, técnica y volumen del material inyectado juegan un papel importante en la patogénesis de este síndrome (2).
El propósito del presente artículo es realizar una revisión de la literatura del síndrome de embolia de silicona líquida, patología poco frecuente, pero que debe ser considerada como posibilidad diagnóstica en el paciente con antecedente de inyección de silicona que se presenta con síntomas respiratorios.
Keywords
Silicone; Pulmonary embolism; injections subcutaneous; pneumoniaSilicona; embolismo pulmonar; inyección subcutánea; neumonía
References
Referencias
1. Hariri LP, Gaissert HA, Brown R, Ciaranello A, Greene RE, Selig MK, Kradin RL. Progressive granulomatous pneumonitis in response to cosmetic subcutaneous silicone injections in a patient with HIV-1 infection: case report and review of the literature. Arch Pathol Lab Med. 2012 Feb;136(2):204-7. htttps://doi.org/10.5858/arpa.2011-0149-CR
2. Villa A, Sparacio F. Severe pulmonary complications after silicone fluid injection. Am J Emerg Med. 2000 May;18(3):336-7. htttps://doi.org/10.1016/s0735-6757(00)90132-3
3. Gurvits GE. Silicone pneumonitis after a cosmetic augmentation procedure. N Engl J Med. 2006 Jan 12;354(2):211-2. htttps://doi.org/10.1056/NEJMc052625
4. Milojevic B. Complications after silicone injection therapy in aesthetic plastic surgery. Aesthetic Plast Surg. 1982;6(4):203-6.
5. García CM, García DF, Luján GP, Herrera SY. Embolia pulmonar por inyección de polipropileno: reporte de un caso. Med Intern Mex [internet]. 2009;25(4):326-9. Disponible en: https://www.medigraphic.com/pdfs/medintmex/mim-2009/mim094l.pdf
6. Ojeda P, Devivero A, Moreno A, Sossa M. Embolismo por silicona: reporte de casos y revisión de la literatura. Rev Colomb Neumol [internet]. 2009;16(3):193-7. Disponible en: http://www.scielo.org.co/pdf/rcneum/v16n3/v16n3a6.pdf
7. Emer J, Levy L. Complications of minimally invasive cosmetic procedures: prevention and management. J Cutan Aesthet Surg [internet]. 2012;5(2):121. Disponible en: http://www.jcasonline.com/text.asp?2012/5/2/121/99451
8. Blanco J, et al, Silicone pneumonitis, diffuse alveolar hemorrhage and acute respiratory distress syndrome from gluteal silicone injections, American Journal of Emergency Medicine (2018), https://doi.org/10.1016/j.ajem.2018.09.022
9. Dawn SK, Elicker BM, Leung JWT, Reddy GP, Gotway MB. The silicone syndrome. Clin Pulm Med. 2006;13(2):146-7. htttps://doi.org/10.1097/01.cpm.0000204209.81384.27
10. Adegunsoye AO, Matchett S, Valentino DJ. Respiratory medicine case reports a 20-year-old woman with rapidly progressive dyspnea and diffuse pulmonary in fi ltrates. Respir Med Case Reports. 2012;5:34-6. http://dx.doi.org/10.1016/j.rmedc.2011.10.004
11. Purdy-payne EK, Green J, Zenoni S, Evans AN, Bilski TR. A serious complication of illicit silicone injections: latent silicone embolization syndrome after incision. Surg Infect (Larchmt). 2015 Aug;16(4):473-7. htttps://doi.org/10.1089/sur.2014.225
12. Gopie P, Sakhamuri S, Sharma A, Solomon S, Teelucksingh S. Acute pneumonitis secondary to subcutaneous silicone injection. Int J Gen Med [internet]. 2011;4:477-9. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3133515&tool=pmcentrez&rendertype=abstract
13. Torres GB, Medrano RG, Priego BRB, Peláez BI, Buergos VR. Enfermedad por la infiltración de sustancias modelantes con fines estéticos. Cir Plast [internet]. 2010;20(3):124-32. Disponible en: https://www.medigraphic.com/pdfs/cplast/cp-2010/cp103e.pdf
14. Mendonca D, Leitao DS, Do RF, Epelboim J, Eiger G. An unusual case of pulmonary embolism. Respir Care. 2012 Aug;57(8):1345-7. htttps://doi.org/10.4187/respcare.01555
15. Restrepo CS, Artunduaga M, Carrillo JA, Rivera AL, Ojeda ÞP, Martínez-Jiménez ÞS, et al. Silicone pulmonary embolism: report of 10 cases and review of the literature. J Comput Assist Tomogr. 2009;33(2):233-7. htttps://doi.org/10.1097/RCT.0b013e31817ecb4e
16. Bejarano A, Bautista DF, Sua LF, Pérez B, Lores J, Aguirre M, Fernández-Trujillo L. Acute pneumonitis and diffuse alveolar hemorrhage secondary to silicone embolism: A case report. Medicine (Baltimore). 2020 Jun 12;99(24):e20578. htttps://doi.org/10.1097/MD.0000000000020578
17. Bartsich S, Wu JK. Silicon emboli syndrome: a sequela of clandestine liquid silicone injections. A case report and review of the literature. J Plast Reconstr Aesthet Surg. 2010;63(1):e1-3. https://doi.org/10.1016/j.bjps.2009.04.004
18. Chen YM, Lu CC, Perng RP. Silicone fluid-induced pulmonary embolism. Am Rev Respir Dis. 1993 May;147(5):1299-302. htttps://doi.org/10.1164/ajrccm/147.5.1299
19. Price EA, Schueler H, Perper JA. Massive systemic silicone embolism: a case report and review of literature. Am J Forensic Med Pathol. 2006 Jun;27(2):97-102. htttps://doi.org/10.1097/01.paf.0000188072.04746.d5
20. Chung KY, Kim SH, Kwon IH, Choi YS, Noh TW, Kwon TJ, Shin DH. Clinicopathologic review of pulmonary silicone embolism with special emphasis on the resultant histologic diversity in the lung--a review of five cases. Yonsei Med J. 2002 Apr;43(2):152-9. https://doi.org/10.3349/ymj.2002.43.2.152
21. Joseph JH. The Case for Synthetic Injectables. Facial Plast Surg Clin North Am. 2015 Nov;23(4):433-45. htttps://doi.org/10.1016/j.fsc.2015.07.003
22. Corradetti B, editora. The immune response to implanted materials and devices: the impact of the immune system on the success of an implant. New York: Springer; 2016.
23. Travis WD, Balogh K, Abraham JL. Silicone granulomas: report of three cases and review of the literature. Hum Pathol. 1985;16(1):19-27. htttps://doi.org/10.1016/s0046-8177(85)80209-4
24. Almansa-Pastor A. ¿Neumotacómetros o neumoflujómetros? [Carta al editor]. Arch Bronconeumol. 2006;42(4):205-6.
25. Parikh R, Karim K, Parikh N, Han P, Daoko J, Shamoon FE. Acute pneumonitis and alveolar hemorrhage after subcutaneous injection of liquid silicone. Ann Clin Lab Sci. 2008;38(4):380-5.
26. Hexsel DM, Hexsel CL, Iyengar V. Liquid injectable silicone: history, mechanism of action, indications, technique, and complications. Semin Cutan Med Surg. 2003 Jun;22(2):107-14. htttps://doi.org/10.1053/sder.2003.50010
27. Hizal E, Buyuklu F, Ozdemir BH, Erbek SS. Long-term inflammatory response to liquid injectable silicone, cartilage, and silicone sheet. Laryngoscope. 2014 Nov;124(11):E425-30. htttps://doi.org/10.1002/lary.24800
28. De March Ronsoni R, Schwingel FL, Melo LH, Zomer de Albernaz R, Lourenço KC, et al. Pulmonary embolism due to liquid silicone: case report. Respit Med Extra. 2007;4(4):172-4. https://doi.org/10.1016/j.rmedx.2007.09.002
29. Pastor E, Andreu AL, Chiner E. Neumonitis aguda y síndrome de distrés respiratorio del adulto tras inyección subcutánea de silicona líquida [Carta al director]. Arch Bronconeumol. 2005;41(12):1993-4.
30. Styperek A, Bayers S, Beer M, Beer K. Nonmedical-grade injections of permanent fillers: Medical and medicolegal considerations. J Clin Aesthet Dermatol. 2013;6(4):22-9.
31. Schenone G. Silicomas mamarios por inyección: clínica, diagnóstico y tratamiento. Buenos Aires: Ediciones Journal; 2017.
32. Schenone GE, editor. Injection-induced breast siliconomas: clinical implications, evaluation and treatment. New York: Springer; 2020.
33. Coiffman F. Alogenosis iatrogénica: una nueva enfermedad. Cir Plást Iberolatinoam [internet]. 2008;34(1):1-10. Disponible en: https://scielo.isciii.es/pdf/cpil/v34n1/01.pdf
34. Andreas S, Assaf T, Lidiya L, Bruce K. Silicone embolism syndrome: a case report, review of the literature , and comparison with fat embolism syndrome. Chest. 2005;127(6):2276-81. https://doi.org/10.1378/chest.127.6.2276
35. Lyapichev K, Chinea FM, Poveda J, Pereda J, Bejarano PA, Garcia-Buitrago MT. Pulmonary empty spaces: silicone embolism—A decade of increased incidence and its histological diagnosis. Case Rep Pathol. 2016;2016:3741291. htttps://doi.org/10.1155/2016/3741291
36. Zamora AC, Collard HR, Barrera L, Mendoza F, Webb WR, Carrillo G. Silicone injection causing acute pneumonitis: a case series. Lung. 2009 Aug;187(4):241-4. htttps://doi.org/10.1007/s00408-009-9150-x
37. Essenmacher AC, Astani SA. Respiratory disease following illicit injection of silicone: A case report. Case Rep Med. 2013;2013(Figure 1):3-6.
38. Azeem A, Khuwaja S, Parthvi R, Persaud T. Pulmonary fibrosis and embolism secondary to silicon implant leak. BMJ Case Rep. 2019 Jun 14;12(6):e229470. htttps://doi.org/10.1136/bcr-2019-229470
39. Narini P, Semple J, Hay J. Repeated exposure to silicone gel can induce delayed hypersensitivity. Plastic and Reconstructive Surgery. Volume 96, Issue 2, Pages 371 – 380. August 1995. htttps://doi.org/10.1097/00006534-199508000-00016
1. Hariri LP, Gaissert HA, Brown R, Ciaranello A, Greene RE, Selig MK, Kradin RL. Progressive granulomatous pneumonitis in response to cosmetic subcutaneous silicone injections in a patient with HIV-1 infection: case report and review of the literature. Arch Pathol Lab Med. 2012 Feb;136(2):204-7. htttps://doi.org/10.5858/arpa.2011-0149-CR
2. Villa A, Sparacio F. Severe pulmonary complications after silicone fluid injection. Am J Emerg Med. 2000 May;18(3):336-7. htttps://doi.org/10.1016/s0735-6757(00)90132-3
3. Gurvits GE. Silicone pneumonitis after a cosmetic augmentation procedure. N Engl J Med. 2006 Jan 12;354(2):211-2. htttps://doi.org/10.1056/NEJMc052625
4. Milojevic B. Complications after silicone injection therapy in aesthetic plastic surgery. Aesthetic Plast Surg. 1982;6(4):203-6.
5. García CM, García DF, Luján GP, Herrera SY. Embolia pulmonar por inyección de polipropileno: reporte de un caso. Med Intern Mex [internet]. 2009;25(4):326-9. Disponible en: https://www.medigraphic.com/pdfs/medintmex/mim-2009/mim094l.pdf
6. Ojeda P, Devivero A, Moreno A, Sossa M. Embolismo por silicona: reporte de casos y revisión de la literatura. Rev Colomb Neumol [internet]. 2009;16(3):193-7. Disponible en: http://www.scielo.org.co/pdf/rcneum/v16n3/v16n3a6.pdf
7. Emer J, Levy L. Complications of minimally invasive cosmetic procedures: prevention and management. J Cutan Aesthet Surg [internet]. 2012;5(2):121. Disponible en: http://www.jcasonline.com/text.asp?2012/5/2/121/99451
8. Blanco J, et al, Silicone pneumonitis, diffuse alveolar hemorrhage and acute respiratory distress syndrome from gluteal silicone injections, American Journal of Emergency Medicine (2018), https://doi.org/10.1016/j.ajem.2018.09.022
9. Dawn SK, Elicker BM, Leung JWT, Reddy GP, Gotway MB. The silicone syndrome. Clin Pulm Med. 2006;13(2):146-7. htttps://doi.org/10.1097/01.cpm.0000204209.81384.27
10. Adegunsoye AO, Matchett S, Valentino DJ. Respiratory medicine case reports a 20-year-old woman with rapidly progressive dyspnea and diffuse pulmonary in fi ltrates. Respir Med Case Reports. 2012;5:34-6. http://dx.doi.org/10.1016/j.rmedc.2011.10.004
11. Purdy-payne EK, Green J, Zenoni S, Evans AN, Bilski TR. A serious complication of illicit silicone injections: latent silicone embolization syndrome after incision. Surg Infect (Larchmt). 2015 Aug;16(4):473-7. htttps://doi.org/10.1089/sur.2014.225
12. Gopie P, Sakhamuri S, Sharma A, Solomon S, Teelucksingh S. Acute pneumonitis secondary to subcutaneous silicone injection. Int J Gen Med [internet]. 2011;4:477-9. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3133515&tool=pmcentrez&rendertype=abstract
13. Torres GB, Medrano RG, Priego BRB, Peláez BI, Buergos VR. Enfermedad por la infiltración de sustancias modelantes con fines estéticos. Cir Plast [internet]. 2010;20(3):124-32. Disponible en: https://www.medigraphic.com/pdfs/cplast/cp-2010/cp103e.pdf
14. Mendonca D, Leitao DS, Do RF, Epelboim J, Eiger G. An unusual case of pulmonary embolism. Respir Care. 2012 Aug;57(8):1345-7. htttps://doi.org/10.4187/respcare.01555
15. Restrepo CS, Artunduaga M, Carrillo JA, Rivera AL, Ojeda ÞP, Martínez-Jiménez ÞS, et al. Silicone pulmonary embolism: report of 10 cases and review of the literature. J Comput Assist Tomogr. 2009;33(2):233-7. htttps://doi.org/10.1097/RCT.0b013e31817ecb4e
16. Bejarano A, Bautista DF, Sua LF, Pérez B, Lores J, Aguirre M, Fernández-Trujillo L. Acute pneumonitis and diffuse alveolar hemorrhage secondary to silicone embolism: A case report. Medicine (Baltimore). 2020 Jun 12;99(24):e20578. htttps://doi.org/10.1097/MD.0000000000020578
17. Bartsich S, Wu JK. Silicon emboli syndrome: a sequela of clandestine liquid silicone injections. A case report and review of the literature. J Plast Reconstr Aesthet Surg. 2010;63(1):e1-3. https://doi.org/10.1016/j.bjps.2009.04.004
18. Chen YM, Lu CC, Perng RP. Silicone fluid-induced pulmonary embolism. Am Rev Respir Dis. 1993 May;147(5):1299-302. htttps://doi.org/10.1164/ajrccm/147.5.1299
19. Price EA, Schueler H, Perper JA. Massive systemic silicone embolism: a case report and review of literature. Am J Forensic Med Pathol. 2006 Jun;27(2):97-102. htttps://doi.org/10.1097/01.paf.0000188072.04746.d5
20. Chung KY, Kim SH, Kwon IH, Choi YS, Noh TW, Kwon TJ, Shin DH. Clinicopathologic review of pulmonary silicone embolism with special emphasis on the resultant histologic diversity in the lung--a review of five cases. Yonsei Med J. 2002 Apr;43(2):152-9. https://doi.org/10.3349/ymj.2002.43.2.152
21. Joseph JH. The Case for Synthetic Injectables. Facial Plast Surg Clin North Am. 2015 Nov;23(4):433-45. htttps://doi.org/10.1016/j.fsc.2015.07.003
22. Corradetti B, editora. The immune response to implanted materials and devices: the impact of the immune system on the success of an implant. New York: Springer; 2016.
23. Travis WD, Balogh K, Abraham JL. Silicone granulomas: report of three cases and review of the literature. Hum Pathol. 1985;16(1):19-27. htttps://doi.org/10.1016/s0046-8177(85)80209-4
24. Almansa-Pastor A. ¿Neumotacómetros o neumoflujómetros? [Carta al editor]. Arch Bronconeumol. 2006;42(4):205-6.
25. Parikh R, Karim K, Parikh N, Han P, Daoko J, Shamoon FE. Acute pneumonitis and alveolar hemorrhage after subcutaneous injection of liquid silicone. Ann Clin Lab Sci. 2008;38(4):380-5.
26. Hexsel DM, Hexsel CL, Iyengar V. Liquid injectable silicone: history, mechanism of action, indications, technique, and complications. Semin Cutan Med Surg. 2003 Jun;22(2):107-14. htttps://doi.org/10.1053/sder.2003.50010
27. Hizal E, Buyuklu F, Ozdemir BH, Erbek SS. Long-term inflammatory response to liquid injectable silicone, cartilage, and silicone sheet. Laryngoscope. 2014 Nov;124(11):E425-30. htttps://doi.org/10.1002/lary.24800
28. De March Ronsoni R, Schwingel FL, Melo LH, Zomer de Albernaz R, Lourenço KC, et al. Pulmonary embolism due to liquid silicone: case report. Respit Med Extra. 2007;4(4):172-4. https://doi.org/10.1016/j.rmedx.2007.09.002
29. Pastor E, Andreu AL, Chiner E. Neumonitis aguda y síndrome de distrés respiratorio del adulto tras inyección subcutánea de silicona líquida [Carta al director]. Arch Bronconeumol. 2005;41(12):1993-4.
30. Styperek A, Bayers S, Beer M, Beer K. Nonmedical-grade injections of permanent fillers: Medical and medicolegal considerations. J Clin Aesthet Dermatol. 2013;6(4):22-9.
31. Schenone G. Silicomas mamarios por inyección: clínica, diagnóstico y tratamiento. Buenos Aires: Ediciones Journal; 2017.
32. Schenone GE, editor. Injection-induced breast siliconomas: clinical implications, evaluation and treatment. New York: Springer; 2020.
33. Coiffman F. Alogenosis iatrogénica: una nueva enfermedad. Cir Plást Iberolatinoam [internet]. 2008;34(1):1-10. Disponible en: https://scielo.isciii.es/pdf/cpil/v34n1/01.pdf
34. Andreas S, Assaf T, Lidiya L, Bruce K. Silicone embolism syndrome: a case report, review of the literature , and comparison with fat embolism syndrome. Chest. 2005;127(6):2276-81. https://doi.org/10.1378/chest.127.6.2276
35. Lyapichev K, Chinea FM, Poveda J, Pereda J, Bejarano PA, Garcia-Buitrago MT. Pulmonary empty spaces: silicone embolism—A decade of increased incidence and its histological diagnosis. Case Rep Pathol. 2016;2016:3741291. htttps://doi.org/10.1155/2016/3741291
36. Zamora AC, Collard HR, Barrera L, Mendoza F, Webb WR, Carrillo G. Silicone injection causing acute pneumonitis: a case series. Lung. 2009 Aug;187(4):241-4. htttps://doi.org/10.1007/s00408-009-9150-x
37. Essenmacher AC, Astani SA. Respiratory disease following illicit injection of silicone: A case report. Case Rep Med. 2013;2013(Figure 1):3-6.
38. Azeem A, Khuwaja S, Parthvi R, Persaud T. Pulmonary fibrosis and embolism secondary to silicon implant leak. BMJ Case Rep. 2019 Jun 14;12(6):e229470. htttps://doi.org/10.1136/bcr-2019-229470
39. Narini P, Semple J, Hay J. Repeated exposure to silicone gel can induce delayed hypersensitivity. Plastic and Reconstructive Surgery. Volume 96, Issue 2, Pages 371 – 380. August 1995. htttps://doi.org/10.1097/00006534-199508000-00016
Cómo citar
Ávila Arenas, L. M., Londoño Duarte, M. P. ., & Ojeda Toro, G. D. . (2022). Síndrome de Embolia por silicona: Una revisión de tema. Universitas Medica, 63(1). https://doi.org/10.11144/Javeriana.umed63-1.embo
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