Systemic sclerosis after augmentation mammoplasty with silicone implants

Article Abstract:

The implantation of elastomer envelopes filled with silicone gel is the procedure of choice in augmentation mammoplasty, the enlargement of breasts for cosmetic purposes. However, chronic inflammation and syndromes resembling connective tissue diseases have occurred, although rarely, in women who have received these implants. Case studies are presented of four women who developed systemic rheumatic sclerosis, or hardening of the connective tissues throughout their bodies, 6 to 15 years after implantation. The patients also had Raynaud's phenomenon, which is characterized by ischemia (decreased blood supply to the extremities of the body), arthralgia (pain that affects a joint), and some gastrointestinal or pulmonary involvement. The lymph nodes near the implant were enlarged. Laboratory tests showed the presence of antinuclear antibodies, which would seem to indicate autoimmune disease, in which the body recognizes its own cells as foreign and mounts an immune response against them. Removal of the implant resulted in the improvement of sclerosis in only two of the cases. Silicone escaped from the semipermeable membrane of the implant, as detected by electron microscope and energy-dispersive analysis. The silicone had spread to the nearby lymph nodes. Cells involved in the inflammation process were observed in the sites that contained the silicone. The occurrence of systemic sclerosis from implantation of silicone in the breast is not common, but because of the potentially long time between implantation and disease development, more cases may be seen in the future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Raynaud's disease, Implants, Artificial, Prostheses and implants, Sclerosis

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Human adjuvant disease: remission of silicone induced autoimmune disease after explantation of breast augmentation

Article Abstract:

Silicone implants frequently provoke localized reactions, but only limited information has been available about systemic side effects. Lung inflammation, elevated calcium levels, and spleen, platelet, and immune system reactions have been reported in the literature. Autoimmune disorders (in which the body makes antibodies against its own tissues) have been reported in 74 cases following silicone or paraffin implantation. A case is reported of a 42-year-old woman who developed an autoimmune disorder after undergoing breast augmentation with silicone, which resolved after removal of the implants. The patient developed irregular heartbeat and breast pain 11 years after breast augmentation. She also had painful finger, elbow, and shoulder joints and diffuse hair loss. Laboratory tests indicated the presence of an autoimmune disease, with resulting alterations in soft tissues, especially near the right implant. Following treatment with non-steroidal anti-inflammatory drugs, the patient decided to have the implants removed. Six months later, laboratory findings of autoimmune disease had decreased or were normal. Removal of implants does not always result in medical improvement. The study suggests that patients considering augmentation should be warned of the possibility of developing autoimmune disease, and follow-up checks should include systemic evaluation with brief immunological screening. (Consumer Summary produced by Reliance Medical Information, Inc.)

Autoimmune diseases

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Exaggerated radiation-induced fibrosis in patients with systemic sclerosis

Article Abstract:

Systemic sclerosis (SSc) is a disease of the connective tissue in which increased amounts of fibrous tissue are deposited in the skin and internal organs. In recent years, ionizing radiation has been used to treat this and some other autoimmune conditions, although ionizing radiation itself may cause fibrosis. New megavoltage irradiation and carefully planned field of focus have helped minimize this side effect. When used properly, fibrosis (deposition of fibrous tissue) is limited and nonprogressive. Four cases are reported of patients with SSc who developed exaggerated fibrotic reactions after localized radiation therapy for cancer. Fibrosis continued beyond the irradiated area, and three of the patients died from the effects. All four of the patients had symptoms of SSc before beginning radiation therapy. In a trial of total lymphoid irradiation for the treatment of SSc, both skin and lung disease worsened. One patient developed severe difficulty with swallowing, and small bowel involvement, ending in death. Fibrosis was limited to the irradiated side of the body. Caution is necessary when treating SSC patients with radiation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Radiotherapy, Systemic scleroderma, Scleroderma (Disease), Fibrosis

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