摘要

Objectives: 1. Recognize characteristic clinical manifestations of ASIA syndrome associated with dermal filler injections, including non-specific cutaneous reactions. 2. Identify typical but non-specific laboratory findings in ASIA syndrome (ANA, CRP, RF) and interpret them in clinical context. 3. Apply the international diagnostic criteria by Shoenfeld et al. (2011) for verification of ASIA syndrome diagnosis in patients with relevant history and symptomatology. 4.Increase clinical awareness and index of suspicion for ASIA syndrome when managing patients with systemic symptoms following filler injections Introduction: Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA) is a well-documented but often underdiagnosed condition. This study aims to illustrate the typical diagnostic pitfalls and the broad clinical polymorphism of ASIA syndrome triggered by dermal fillers through a series of clinical observations. Materials / method: A retrospective analysis was conducted on four clinical cases (all female, aged 36-56) who presented to our clinic between 2022 and 2024 with systemic inflammatory symptoms following injections of various dermal fillers. The diagnosis of ASIA syndrome was verified using the established international diagnostic criteria by Shoenfeld et al. (2011). All patients underwent a comprehensive clinical and laboratory workup, including a broad panel of autoantibodies (ANA, RF, anti-dsDNA), inflammatory markers (CRP, ESR), and instrumental diagnostics (soft tissue ultrasonography, and MRI when indicated) Results: ASIA syndrome was confirmed in all four patients.The most frequent clinical manifestations were non-specific cutaneous reactions(100%),chronic fatigue(100%),and arthralgia(75%).Three out of four patients tested positive for ANA at low titers (1:160-1:320).All patients exhibited persistently elevated C-reactive protein (CRP) levels.The mean latency period between the procedure and symptom onset was 8 months (range:2 weeks to 18 months).A recurrent,non-specific cutaneous reaction was observed in three cases.Further investigation led to a first-time diagnosis of a concomitant autoimmune disease Conclusion: These cases underscore that ASIA syndrome is a critical differential diagnosis in patients presenting with systemic inflammatory and autoimmune symptoms and a history of dermal filler injections. Diagnosis relies heavily on a meticulous patient history and the application of clinical criteria, as laboratory markers are often non-specific. There is a pressing need for heightened awareness of this pathology among physicians across specialties, including dermatologists, aesthetic practitioners, and rheumatologists.