Table 2.
Criteria suggested ASIA diagnosis
| Exposure to an external stimuli (Infection, vaccine, silicone, adjuvant) prior to clinical manifestations | |
|---|---|
| Major criteria | The appearance of ’typical’ clinical manifestations: |
| Myalgia, Myositis or muscle weakness | |
| Arthralgia and/or arthritis | |
| Chronic fatigue, un-refreshing sleep or sleep disturbances | |
| Neurological manifestations (especially associated with demyelination) | |
| Cognitive impairment, memory loss | |
| Pyrexia, dry mouth | |
| Removal of inciting agent induces improvement | |
| Typical biopsy of involved organs | |
| Minor criteria | The appearance of autoantibodies or antibodies directed at the suspected adjuvant |
| Other clinical manifestations (i.e. irritable bowel syn.) | |
| Specific HLA (i.e. HLA DRB1, HLA DQB1) | |
| Evolvement of an autoimmune disease (i.e. MS, SSc) |
For the diagnosis of ASIA, the presence of at least 2 major or 1 major and 2 minor criteria must be apparent. Table reprinted from Journal of Autoimmunity, vol. 36(1), Yehuda Shoenfelda and Nancy Agmon-Levin, ‘ASIA’—Autoimmune/inflammatory syndrome induced by adjuvants, pages 4–8, Copyright 2011, with permission from Elsevier