Clinical study of human adjuvant disease

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  • ZEN HOU
    Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine
  • FUKAZAWA TORU
    Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine
  • SEOK YANG KWANG
    Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine
  • KUMAGAI YASUO
    Department of Internal Medicine, Imaichi Hospital
  • HASHIMOTO HIROSHI
    Department of Internal Medicine, Juntendo University Koshigaya Hospital
  • TAKASAKI YOSHINARI
    Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine

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Other Title
  • ヒトアジュバント病に関する臨床的検討
  • ヒトアジュバントビョウ ニ カンスル リンショウテキ ケントウ

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Abstract

Objective : The concept of human adjuvant disease has been a focus of discussion in recent years. We reviewed the characteristics of 21 patients with symptoms and signs of connective tissue diseases who had undergone cosmetic surgery that involved foreign substances such as silicone and paraffin. The relationship between cosmetic surgery and the incidence of human adjuvant disease was studied. Subjects : The subjects were 21 patients with symptoms and signs of connective tissue diseases after cosmetic surgery who were treated at the Division of Rheumatology of Juntendo University Hospital between January 1980 and December 2004. The patients were between 27 and 75 years of age (mean : 61.3±10.0years), and there were 19 women and 2 men. Methods : (1) The patients were classified into two groups, group I consisted of 14 patients satisfying the published criteria for definite connective tissue disease, while group II consisted of 7 patients diagnosed as having human adjuvant disease who had 1 or more features of connective tissue disease, but not enough to be classified in group I. We compared groups I and II in terms of the interval between cosmetic surgery to symptom onset, clinical and laboratory findings. (2) We compared our subjects and another group of 29 human adjuvant disease patients reported by Kumagai in 1989 in terms of clinical characteristics. (3) We also compared the incidence of each connective tissue disease in group I with the incidence of these diseases in Japan. Results : (1) There was no significant difference between the 2 groups regarding the interval between cosmetic surgery and onset. The autoantibody positive rate was higher in group I than in group II. (2) Our study and that by Kumagai showed that human adjuvant disease might be related to systemic sclerosis, and our data suggested that human adjuvant disease is also related with Sjören's syndrome. (3) Systemic sclerosis and Sjören's syndrome in group I showed a higher incidence than the incidence reported in the general population in Japan. Discussion : These findings suggest that cosmetic surgery is related to systemic sclerosis and Sjören's syndrome. However, interval between cosmetic surgery and onset was long, and there is no experimental evidence indicating that foreign substances play a role in the induction of immunologic disorders ; therefore, the relation between human adjuvant disease and cosmetic surgery is not clear. It will be necessary to analyze the immune response of patient lymphocytes or macrophages to foreign substances in the future.

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