Longitudinal changes in minerals are influenced by immunosuppressive treatment in men with granuloma disease

To investigate whether granuloma formation following self-administered cosmetic oil injections affects mineral homeostasis, specifically calcium, magnesium, phosphate, iron, sodium, and potassium, and to assess the potential impact of prednisolone treatment on these mineral levels.

In this retrospective study, we reviewed blood samples from baseline through a follow-up period of 48 months in patients referred to a tertiary center at Herlev Hospital, Denmark. Changes in serum minerals over time were assessed by a linear mixed model for repeated measures.

A total of 111 patients were included. Men who injected > 2,000 mL paraffin oil had higher total and ionized calcium (p = 0.029 and p < 0.001), lower PTH (p < 0.001), but also lower magnesium (p < 0.001) and higher sodium (p = 0.048) compared to those who had injected < 500 mL. Men with manifest hypercalcemia at baseline (n = 32) compared to men with normocalcemia (n = 79) experienced an increase in serum PTH and phosphate concentrations over time (p = 0.042 at 48 months), and also a transient increase in iron concentration, although this reached baseline levels again after 24 months. Prednisolone lowered calcium in hypercalcemic men but also decreased serum magnesium (p = 0.027 after 36 months), phosphate, and increased serum iron concentration.

Men who had injected large volumes of paraffin oil were more likely to have hypercalcemia, lower magnesium, and higher sodium concentrations. Minor aberration in serum minerals was more frequent in patients with more pronounced disease and this may likely be a poor prognostic sign although the mechanism behind this observation remains unclear.