Classification for Staging and Managing Patients with Biopolymer-induced Human Adjuvant Disease

Biopolymer-induced human adjuvant disease (BHAD) is a chronic clinical condition that requires surgical intervention, regardless of the presence of symptoms, to minimize the risk of functional, aesthetic, and systemic sequelae and the development of conditions simulating autoimmune disease. We propose a classification for BHAD on the basis of course of the disease, which will make it possible to assess the damage and difficulty in patients, leading to a more appropriate therapeutic approach. METHODS: A protocol study was implemented. A casuistry of patients with a diagnosis of autoimmune/inflammatory syndrome induced by adjuvants was taken into account according to the Shoenfeld criteria. Qualitative variables were analyzed through frequencies and percentages, and quantitative variables were analyzed with measures of central tendency and dispersion. The diagnostic validity of the signs and symptoms was analyzed using some paraclinical tests. RESULTS: A total of 190 patients diagnosed with autoimmune/inflammatory syndrome induced by adjuvants with biopolymers in the buttocks and who underwent a surgical procedure by the open, masked technique between January 2017 and December 2020 were selected. Considering each sign and symptom, the location of the biopolymers in different planes, and pathophysiology of the clinical course of the disease, a classification was proposed that takes into account diagnostic imaging findings, local clinical signs, systemic symptoms, systemic clinical signs, and autoimmune markers. CONCLUSION: Some signs associated with biomarkers with sensitivity and specificity values can influence the pretest decision to request paraclinicals, improving the diagnostic probability and cost effectiveness in these patients.