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Published on: February 29, 2020

A case of abdominal CSF pseudocyst associated with silicone allergy

Masanori Hashimoto1, Akira Yokota, Eiichirou Urasaki

  • 1Department of Neurosurgery, University of Occupational and Environmental Health, Iseigaoka 1-1, 807-8555 Yahata-Nishi, Kitakyushu, Japan. masanori@med.uoeh-u.ac.jp

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 5, 2004
PubMed

Insights

An allergic reaction to silicone caused an abdominal cerebrospinal fluid (CSF) pseudocyst in a patient with a meningomyelocele and Chiari II malformation. Using a silicone shunt with extracted allergens resolved the pseudocyst and shunt malfunction.

Area of Science:

  • Neurology
  • Allergy and Immunology
  • Pediatric Surgery

Background:

  • A case report details a pediatric patient with meningomyelocele and Chiari II malformation who received a ventriculoperitoneal (V-P) shunt at 6 months of age.
  • Abdominal cerebrospinal fluid (CSF) pseudocyst formation and V-P shunt malfunction occurred 40 days post-insertion.

Observation:

  • Diagnostic findings included elevated peripheral eosinophils, increased serum immunoglobulin E (IgE), and eosinophilic infiltration in the pseudocyst wall.
  • These indicators strongly suggested an allergic reaction to silicone as the etiology of the pseudocyst.

Findings:

  • A sixth surgical revision of the V-P shunt was performed.
  • The revision utilized a shunt system composed of "extracted silicone," with allergic substances removed.

Implications:

  • Post-revision, serum IgE levels normalized, and the abdominal CSF pseudocyst did not recur over a 22-month follow-up period.
  • This case highlights the potential for silicone allergy to cause CSF pseudocysts and shunt complications, suggesting specialized shunt materials may be beneficial.
Abstract

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