Hyaluronic acid-induced diffuse alveolar hemorrhage: unknown complication induced by a well-known injectable agent

Annals of Translational Medicine
Seoung Woo HanSeung Hyeun Lee

Abstract

Hyaluronic acid (HA) is widely used in medicine, especially for contouring or volumizing soft tissue and intra-articular injection. However, it is not well known that HA injection can cause life-threatening pulmonary complications. We recently experienced a case of a woman who was diagnosed with diffuse alveolar hemorrhage (DAH) after receiving an illegal vaginal HA filler injection. A 54-year-old female visited our clinic complaining of hemoptysis and dyspnea. Chest computed tomographic (CT) scan showed diffuse ground glass opacities and consolidation in both lower lobes. Bronchoalveolar lavage (BAL) disclosed hemorrhagic feature in sequential samples compatible with DAH. There were no relevant drugs or past medical histories, and no positive result in autoantibodies tests. During detailed history taking, she recalled that she got an illegal HA filler injection in her vaginal wall performed by nonmedical personnel the very day before the onset of symptoms. Although the procedure itself or an additive of HA preparation could be a cause, HA that might have been introduced into circulation was thought to be the most possible cause for the development of DAH. The clinical symptoms and lung lesions were dramatically improved after ...Continue Reading

Citations

Jan 30, 2020·Pharmaceutics·Kaoru Aoki, Naoto Saito
Oct 14, 2019·Aesthetic Surgery Journal·Yang YangXiangdong Qi
Aug 20, 2020·The Journal of International Medical Research·Chenyu WangXiao Long
Jan 28, 2021·Archives of Plastic Surgery·Byeong Soo Kwon, Jin Woo Kim
Mar 3, 2021·Aesthetic Plastic Surgery·Zhifang ZhengWenhua Huang
Mar 18, 2021·World Journal of Clinical Cases·Xiang-Ning ZhangZhi-Wei He
Jan 30, 2021·Aesthetic Surgery Journal·Greg J GoodmanMichael Clague
Jul 24, 2021·Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace·Amira Aishah Che AniAzman Abd Hamid

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