https://doi.org/10.4081/monaldi.2021.1845

Diffuse alveolar haemorrhage and myocardial infarction: life-threatening effects from self-injected hyaluronic acid dermal filler

Vol. 91 No. 4 (2021)
Submitted: March 13, 2021
Accepted: June 11, 2021
Published: July 22, 2021
hyaluronic acid, respiratory distress syndrome, hemorrhage, myocardial infarction, dermal fillers
Abstract Views: 1187
PDF: 550
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Authors

Amira Aishah Che Ani
miranomey@yahoo.com
https://orcid.org/0000-0001-9256-4572
Department of Anaesthesiology and Critical Care, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia.
Sakinah Mohd Akhir
https://orcid.org/0000-0001-7542-5175
Department of Anaesthesiology and Critical Care, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia.
Winnie Chiang Li-Xue
https://orcid.org/0000-0002-6297-5028
Department of Anaesthesiology and Critical Care, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia.
Nur Zurairah Shahidan
Department of Anaesthesiology and Critical Care, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia.
Azman Abd Hamid
https://orcid.org/0000-0002-3801-3785
Department of Anaesthesiology and Critical Care, Hospital Tuanku Fauziah, Perlis, Ministry of Health, Malaysia.

Hyaluronic acid (HA) is a widely used dermal filler for soft tissue augmentation. We described a case of a 38-year-old transwoman who presented with sudden onset of severe respiratory distress following self-injection of HA dermal filler. She developed multiple episodes of pulmonary haemorrhage, and her chest X-ray showed diffuse ground-glass opacities consistent with diffuse alveolar haemorrhage (DAH). There were no relevant drugs or past medical histories. Anti-nuclear antibodies and rheumatoid factor were negative. Initially, the pulmonary haemorrhage episodes and ventilation requirement improved with systemic steroid, however she subsequently developed acute myocardial infarction with progressive clinical deterioration leading to death. To the best of our knowledge, this is the first HA-related DAH with myocardial infarction reported with a fatal outcome. This case highlights the importance of awareness and the necessity of having a high suspicion of DAH in patients with history of illicit HA dermal filler use.

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How to Cite

Che Ani, Amira Aishah, Sakinah Mohd Akhir, Winnie Chiang Li-Xue, Nur Zurairah Shahidan, and Azman Abd Hamid. 2021. “Diffuse Alveolar Haemorrhage and Myocardial Infarction: Life-Threatening Effects from Self-Injected Hyaluronic Acid Dermal Filler”. Monaldi Archives for Chest Disease 91 (4). https://doi.org/10.4081/monaldi.2021.1845.
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