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Clin Rheumatol. 2018 Feb;37(2):483-493. doi: 10.1007/s10067-017-3748-9. Epub 2017 Jul 25.

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld's syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry.

Author information

1
Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated to Tel-Aviv University), 5265601, Tel-Hashomer, Israel.
2
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
3
Department of Medicine A, Centro Hospitalar do Porto, Porto, Portugal.
4
School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
5
Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain.
6
Clinical and Experimental Immunology, Reinaert Clinic, Maastricht, The Netherlands.
7
Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated to Tel-Aviv University), 5265601, Tel-Hashomer, Israel. shoenfel@post.tau.ac.il.
8
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. shoenfel@post.tau.ac.il.
9
Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Tel-Aviv University, Tel-Aviv, Israel. shoenfel@post.tau.ac.il.

Abstract

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a recently identified condition in which the exposure to an adjuvant leads to an aberrant autoimmune response. We aimed to summarize the results obtained from the ASIA syndrome registry up to December 2016, in a descriptive analysis of 300 cases of ASIA syndrome, with a focus on the adjuvants, the clinical manifestations, and the relationship with other autoimmune diseases. A Web-based registry, based on a multicenter international study, collected clinical and laboratory data in a form of a questionnaire applied to patients with ASIA syndrome. Experts in the disease validated all cases independently. A comparison study regarding type of adjuvants and differences in clinical and laboratory findings was performed. Three hundred patients were analyzed. The mean age at disease onset was 37 years, and the mean duration of time latency between adjuvant stimuli and development of autoimmune conditions was 16.8 months, ranging between 3 days to 5 years. Arthralgia, myalgia, and chronic fatigue were the most frequently reported symptoms. Eighty-nine percent of patients were also diagnosed with another defined rheumatic/autoimmune condition. The most frequent autoimmune disease related to ASIA syndrome was undifferentiated connective tissue disease (UCTD). ASIA syndrome is associated with a high incidence of UCTD and positive anti-nuclear antibodies (ANA) test. Clinical and laboratory features differ from the type of adjuvant used. These findings may contribute to an increased awareness of ASIA syndrome and help physicians to identify patients at a greater risk of autoimmune diseases following the exposure to vaccines and other adjuvants. The ASIA syndrome registry provides a useful tool to systematize this rare condition.

KEYWORDS:

ANA; Adjuvants; Autoantibodies; Autoimmune diseases; Chronic fatigue syndrome (CFS); Fibromyalgia; Silicone; Systemic lupus erythematosus; Vaccines

PMID:
28741088
DOI:
10.1007/s10067-017-3748-9
[Indexed for MEDLINE]

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