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Auto immune disease and mesh rejection
Sandiego,
My inclination to your question is: YES!
We have no proof that patients with autoimmune disorders have a different reaction to mesh than others. However, in my experience, I have anecdotally noticed that patients with lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome have had a prolonged and abnormally high inflammatory response (aka pain) to mesh implantation. Removal of the mesh has resolved their flare up.
I systematically do not place mesh in such patients. If they need mesh, I choose a Biologics tissue with low inflammatory potential (but higher risk for recurrence). There are also hybrid meshes coming to the market that have very little synthetic mesh.
I wish to have an opportunity to study this patient population. To date, no blood tests are abnormal among them to help predict this mesh reaction.