Granulomatous reaction

Three further cases of granulomatous reactions at leuprorelin injection sites in Japanese men have led to speculation that they occur more often in Japan because of the use of subcutaneous injection rather than intramuscular injection, which is used in Western countries (46). The exact mechanism of this reaction is unknown, and whether it is due to the co-polymer or leuprorelin itself is debated. Local reactions can cause reduced efficacy (47). 

Blepharopigmentation with Al-silicate has been introduced during the last decade as a technique for creating a permanent line along the eyelid margin, thus simulating a cosmetic eyeliner. Patients can have a delayed hypersensitivity granulomatous reaction [179]. 

Saffiotti U, Stinson SF. 1988. Lung cancer induction by crystalline silica Relationships to granulomatous reactions and host factors. J Environ Sci Health 6 197-222. 

An exudative granulomatous reaction started 2 days after the injection of hyaluronic acid (Hylaform) (dose not stated) for perioral wrinkles (7). The eczematous papular skin changes disappeared completely within 6 weeks, and could be provoked by intracutaneous testing with Hylaform (dose not stated). Histological examination showed a foreign body granuloma. 

Raulin C, Greve B, Hartschuh W, Soegding K. Exudative granulomatous reaction to hyaluronic acid (Hylaform). Contact Dermatitis 2000 43(3) 178-9. 

There have been many reports of so-called paraffinomas, benign tumors due to granulomatous reactions, in patients using paraffin. 

Foreign body giant cell granulomas were first reported after liquid silicone injection in 1965 (14) and are usually observed near siUcone-injected areas (15). There have been many reports of cysts and granulomatous reactions to silicone at application sites and distal sites after hematogenous or lymphatic migration (15-17). 

Teuber SS, Reilly DA, Howell L, Oide C, Gershwin ME. Severe migratory granulomatous reactions to silicone gel in 3 patients. J Rheumatol 1999 26(3) 699-704. 

Distant granulomatous reactions occurred in an elderly man, who developed sjmptomless lymph node histiocytosis, which was discovered incidentally. 

Peoc h M, Pasquier D, Ducros V, MouUu C, Bost F, Fame C, Pasquier B. Reactious grauulomateuses systemiques et prothese de hauce. Deux observations anatomocliniques. [Systemic granulomatous reaction in hip prosthesis. Apropos of 2 anatomocUnical cases.) Rev Chir Orthop Reparatrice Appar Mot 1996 82(6) 564-7. 

Topical zirconium can cause hypersensitivity granulomas in sensitized persons, which has led to the removal of zirconium salts from antiperspirants (SEDA-22, 242). Complexes of zirconium and aluminum are non-sensitizing and are still commonly used as active ingredients in topical antiperspirants. However, a granulomatous reaction to this material has been reported (1). 

Injection of silicones into tissues may cause granulomatous reactions. Accidental intravascular injection has been associated with fatalities. 

Chronic oral consumption of mineral oil may impair the appetite and interfere with the absorption of fat-soluble vitamins. Prolonged use should be avoided. Mineral oil is absorbed to some extent when emulsified and can lead to granulomatous reactions. Similar reactions also occur upon injection of the oil ° injection may also cause vasospasm. 

Granulomatous reactions and peritonitis at operation sites have been attributed to contamination with surgical glove powders containing sterilizable maize starch. " The use of excessive quantities of sterilizable maize starch on surgeons gloves should therefore be avoided. 

It is slightly absorbed into the intestinal wall where it may set up foreign-body granulomatous reactions. 

In patients with hepatosplenic candidiasis, as the WBC count increases to more than 1000 ceUs/mm, imaging smdies can detect the presence of abscess or microabscesses in the liver and spleen, often found with acute suppurative and granulomatous reactions. 

Hepatosplenic candidiasis—Clinical presentation often manifested only as fever while a patient remains neutropenic (<1000 WBC/ mm ). When the WBC count increases to >1000 cells/mm, imaging studies can detect the presence of abscess or microabscesses in the liver and spleen, often found with acute suppurative and granulomatous reactions. Infection may persist for months and ultimately cause the patient s death despite aggressive systemic therapy with antifungal agents. Also known as chronic systemic candidiasis. 

Live bacillus Calmette-Guerin (BCG TICE BCG, theracys) is an attenuated culture of the bacillus of Calmette and Guerin strain o/Mycobacterium bovis, which induces a granulomatous reaction at the site of administration. By unclear mechanisms, this preparation is active against tumors and is indicated for treatment and prophylaxis of carcinoma in situ of the u rinary bladder and for prophylaxis of primary and recurrent stage Ta and/or T1 papillary tumors after transurethral resection. Adverse effects include hypersensitivity, shock, chills, fever, malaise, and immune complex disease. 

HEALTH SYMPTOMS inhalation (cough, rhinitis, dyspnea, vomiting, cumulative lung damage) eye contact (induces granulomas in and about the eye, conjunctival inflammation) skin contact (can induce severe granulomatous reaction when introduced into wounds). 

Agostini C, Cassatella M, Zambello R, Trentin L, Gasperini S, Perin A, Piazza F, Siviero M, Facco M, Dziejman M, Chilosi M, Qin S, Luster AD, Semenzato G. Involvement of the IP-10 chemokine in sarcoid granulomatous reactions. J Immunol 1998 161 6413-6420. 

Toxicology Silicone-relaled diseases can occur, e.g., silicone-induced synovitis and lymphadenopathy, acute and chronic pneumonitis from bleeding from mptured bag-gel breast implants, pulmonary lesions, granulomatous reactions... 

In humans, liquid silicone has been injected subcutaneously for cosmetic reasons. Granulomatous reactions have been reported to occur in some instances [14-17]. Similar reactions have been noted in two case reports following the rupture of silicone gel-filled breast prostheses [24,25]. Clinically, these reactions have the characteristics of an inflammatory response, i.e., redness, swelling, and pain. Histologic examination shows chronic inflammatory reactions, occasionally with the presence of refrac-tile material resembling silicone [24]. 

---