Lethal Buttock Injection (And Other Toxicities of Illegal Cosmetic Body Fillers)

The Poison Lab

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3y ago 55:42

MP3•Pagina principale dell'episodio

Music in this episode from pixabay.com

Intro
- Case report of hemolysis after sodium deoxycholate injection
History
Epidemiology
Common injection practices
Toxicity
- Infection
  - Self explanatory
- Filler embolism
  - Review 1, Review 2, Review 3
    - Filler lodges in pulmonary vasculature->clotting, bleeding, inflammation
    - 95% occur within 72 hours
    - Primarily respiratory symptoms (cough/hypoxemia)
    - Chest x ray ground glass opacity
    - Treat with supportive care (oxygen all the way through ECMO) +/- steroids
- Filler Blindness
  - CRAO from body filler
  - No effective treatment (exception, can use hyaluronidase if filler is hyaluronic acid)
- Granuloma
  - Inflammatory nodules from prolonged filler exposure
    - May occur months to year after injection
    - Illegal cosmetic= frequently lipogranuloma due to oil being present in many illegal cosmetic
- Granulomatous hypercalcemia
  - Excess calcitriol production from ganuloma causes hyperCA
  - Can be extremely delayed (up to 28 years)
  - Recurrence up to 45%
  - Treat with standard therapies (fluid, bisphosphonate) + steroids and/or ketoconazole to turn down granuloma CYP27B1 calcitriol production
Case from the show
- Some details changed for educational purposes

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