Raynaud's Phenomenon and Scleroderma Associated with Silicone Gel Breast Implants: An Example of Asia Syndrome (original) (raw)
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Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature
Case Reports in Rheumatology, 2014
Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud's phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.
Silicone breast implants and autoimmune rheumatic diseases: myth or reality
Current opinion in rheumatology, 2017
In the present review, recent findings regarding silicone breast implants (SBIs) complicated by rheumatic autoimmune diseases are described. Despite changes in the principal constituents of the silicone implants during the past 50 years, silicone remained an adjuvant that may 'bleed' and subsequently may be a chronic stimulus to the immune system resulting in similar clinical manifestations as 50 years ago. Silicones are spread throughout the body and can be detected in tissues and the central nervous system. Autoimmune/inflammatory syndrome by adjuvants (ASIA), allergies, autoimmune diseases, immune deficiencies and lymphomas occur in patients with SBIs. There is a need for adequately adjusted epidemiological studies to ascertain the frequency of these diseases. Explantation of the breast implants, however, should be advised to patients with complaints, as 60-80% of patients show an amelioration of the signs and symptoms after explantation. SBIs are associated in a proporti...
Archives of Breast Cancer
Background: Autoimmune/inflammatory syndrome (ASIA) constitutes a set of related immune mediated diseases that share a common clinical picture and a history of a previous exposure to an adjuvant agent. From a clinical standpoint, patients present with none specific manifestations such as myalgia, arthralgia, chronic fatigue and dry mouth as well as neurological manifestations such as cognitive disturbances, memory loss and neurologic disabilities. .Case presentation: A previously healthy 25-year-old patient who underwent breast augmentation 3 years ago, with an asymptomatic rupture of the silicone breast implant, presented with three major criteria of ASIA, and improved after bilateral implant removal. She also had pleuritis and pericarditis, rarely described in such disease. A literature review on complications related to breast implants, their questionable relationship to the onset of autoimmune pathologies, and basic aspects of the diagnosis and management of ASIA was carried out...
Granulomatous Inflammatory Reaction in Breast Silicone Implants
Introduction: breast implants have been used to correct the size and the form of a breast in post-mastectomy breast reconstruction, for correcting congenital defects and deformities or for purely aesthetic breast augmentation. Silicone breast implants were introduced in the 1960s. They are non without complications, like rupture is or silicone gel bleeding. Materials and methods: the authors present the case of 50 patients, aged 45-55, who presented to our attention after 15 (+ 5) years of the application of silicone breast implant for the appearance of lumps under the skin in the armpit area. These were palpable, painless except on palpation. The patients reported burning in the affected area, but no other symptoms. Results: considering the presence in each of them of silicone implants, and assuming a possible allergic basis, the authors performed a patch test series SIDAPA produced by F.I.R.M.A Spa, Firenze, ultrasound and MR and blood tests. In all patients the allergy test (patc...
Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study
The Netherlands journal of medicine, 2013
Since their introduction, the safety of silicone breast implants has been under debate. Although an association with systemic diseases was never established, women continuously blamed implants for their unexplained systemic symptoms. In 2011, a pattern of symptoms caused by systemic reactions to adjuvants (e.g. vaccines, silicone) was identified: 'autoimmune syndrome induced by adjuvants' (ASIA). Our aim was to collect a cohort of women with silicone breast implants and unexplained systemic symptoms to identify a possible pattern and compare this with ASIA. Women with silicone breast implants and unexplained systemic symptoms were invited through national media to visit a special outpatient clinic in Amsterdam. All were examined by experienced consultant physicians and interviewed. Chest X-ray and laboratory tests were performed. Between March 2012 and 2013, 80 women were included, of which 75% reported pre-existent allergies. After a symptom-free period of years, a pattern ...
The association between silicone implants and both antibodies and autoimmune diseases
Clinical Rheumatology, 2008
Silicones are widely used materials in many fields of medicine and largely are believed to be biologically inert. However, some investigators have reported that silicone implants are associated with an increased incidence of autoimmune disorders. In this study, we evaluated the capsular tissue of silicone implants and the sera of implant patients and controls for antisilicone antibodies and nonspecific immunoglobulins (IgG, IgA, IgM, and IgE). Our study group included 15 patients (eight men and seven women) undergoing reconstructive procedures for burn scars, in whom we used silicone implants, and 15 sex-matched controls undergoing reconstructive surgery for burn scars without using silicone implants. By immunofluorescence, we discovered strong capsular binding of IgG and weak capsular binding of IgM; antisilicone antibody levels were significantly higher in capsular tissue than elsewhere. Serum IgE also was higher in patient vs control subject sera. In conclusion, silicone materials do lead to an immune response consisting of antisilicone antibodies most evident immediately adjacent to the implant itself.
Systemic Inflammatory Reaction After Silicone Breast Implant
Aesthetic Plastic Surgery, 2011
Background Systemic inflammation after augmentation mammaplasty with modern silicone implants is not currently recognized. In a prospective controlled study, C-reactive protein and other variables were monitored, aiming to test this hypothesis in a young cohort of patients. Methods Females (18-30 years old, BMI = 18.5-30 kg/m 2 , N = 52) were consecutively recruited for breast implant (n = 24, Group I) and for abdominal liposuction (n = 28, Group II/Controls). Patients were interviewed at baseline and followed until 6 months after operation. Variables included demographic and clinical information, surgical outcome, inflammatory markers and autoantibodies. Results Operations were well tolerated, without surgical or infectious complications. Mean prosthesis size was 258 ± 21 ml (range = 220-280) and mean aspirate of liposuction was 1972 ± 499 ml (range = 1200-3000). Preoperative, 2-month, and 6-month C-reactive protein concentrations for breast implant patients were 1.3 ± 1.2,
Antinuclear autoantibodies in women with silicone breast implants
The Lancet, 1992
Clinical syndromes resembling autoimmune diseases have been reported in women who have had breast augmentation procedures. To see whether there is a humoral immune response in these diseases that is similar to the immune response in their idiopathic counterparts, we assessed the immunological specificity of antinuclear antibodies (ANAs) and certain epidemiological features in 24 patients, all of whom (with 1 exception) had received silicone gel breast implants. ANA specificities were identified by indirect immunofluorescence, immunodiffusion, western blot analysis, and immunoprecipitation of radiolabelled intracellular proteins.
Silicone-specific blood lymphocyte response in women with silicone breast implants
Clinical and Vaccine …, 1994
A blinded cross-sectional study was carried out with 99 women, 44 of whom had silicone breast implants. Group I consisted of 55 healthy volunteer women without breast implants; group II comprised 13 volunteer women with breast implants or explants who felt healthy; group III comprised 21 volunteer women with breast implants who had chronic fatigue, musculoskeletal symptoms, and skin disorders; and group IV comprised 10 women who had their prostheses explanted but still presented with clinical symptoms similar to those of the women in group III. Proliferative responses of peripheral blood mononuclear cells from all 99 women were measured by [3 H]thymidine uptake after exposure to SiO2, silicon, or silicone gel. The levels of proliferative responses were expressed as stimulation indices, which were obtained by dividing the counts per minute of stimulated cells by the counts per minute of unstimulated cells. Abnormal responses to SiO2, silicon, or silicone gel were defined as a stimulation index of >2.8, >2.1, or >2.4, respectively. Abnormal responses were observed in 0%1 of group I, 15% of group 1, 29%o of group Ill, and 30%o of group IV (P < 0.0005 for group I versus groups II and IV). Thirty-one percent of symptomatic women with silicone gel breast implants had elevated serum silicon levels (>0.18 mg/liter); however, there was no significant correlation between abnormal cellular responses and silicon levels in blood serum, type of implant, time since first implantation, prosthesis explantation, number of implants, or report of implant leakage or rupture. Flow cytometric and cell depletion
Granulomatous dermatitis related to silicone implant
Dermatology online journal, 2013
Silicone in liquid and gel implantation may induce granuloma formation and migration. Although there are many complications associated with solid silicone implantation, there have been no published reports of distant granuloma formation. We present a case of a woman with clinical and serologic findings that are consistent with systemic lupus erythematosus and a histopathologic diagnosis of foreign body granulomatous dermatitis 20 years after solid silicone nasal implantation. We review the literature on silicone granulomas and their treatment and speculate on the potential etiologies of a challenging case presentation.