ASIA syndrome and the nociceptive storm: A case report of a refractory headache and a pathophysiological hypothesis
Luana Miyahira Makita, Giovanna Grossklags Locatelli, Giovanna Porreca Josetti, Giovana Takeshita Itimura, Elcio Juliato PiovesanBackground
Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses a set of immune rare diseases triggered by adjuvants, like silicone. Although headache is typical in these cases, the literature lacks information about its characteristics and pathophysiology in ASIA.
Objective
Describe and discuss a case of ASIA with headache as the main symptom, approaching its immunopathological and clinical aspects.
Case
A 45-year-old woman with silicone prosthesis presented an intense headache, accompanied by chronic fatigue, sleep and skin disturbances, paresthesia, and generalized body aches. She had sought medical care over the past 2 years, with no underlying identified until then. The fulfillment of ASIA diagnostic criteria and subsequent prosthesis explantation resulted in symptom resolution.
Conclusion
Additional research is required to understand the semiotic patterns linked to ASIA syndrome-induced headaches. A dysregulation in histaminergic GPCR and GRK levels is hypothesized by the authors to be involved in the main mechanisms responsible for leading the headache nociceptive storm induced in ASIA.