title: Norplant: systemic immunological complications--case report.
abstract: The Norplant* system is composed of a set of six Silastic* (silicone polydimethysiloxane) capsules measuring 34 mm by 2.4 mm, each containing 36 mg of levonorgestrel and sealed at either end with a medical grade silicone elastomer adhesive. Levonorgestrel is a synthetic progestin, widely used in combination oral contraceptives and in single-agent "mini-pills". In a procedure completed in less than 15 minutes by an experienced physician, the six capsules are surgically implanted subdermally, most commonly on the inside of the left upper arm. The levonorgestrel diffuses through the Silastic material into the blood stream and is carried to the target organs. Ovulation is suppressed in the majority of the cycles during the first years of use, and cervical mucus is thickened, inhibiting sperm penetration. During use, the effective delivery of levonorgestrel is about 30 mcg/day from day 500 to day 2300. Recently, we have seen patients with complications from Norplant, and we describe here a patient who presented with systemic complications resulting from both the endocrinological aspects of Norplant and the immunological aspects of the Silastic implants. To our knowledge this is the first case report in the western medical literature describing systemic immunological complications as a result of a failed Norplant device.
authors.affiliation: Center for Immune, Environmental, and Toxic Disorders and University of Texas Health Science Center, Houston.
authors.forename: A
authors.initials: A
authors.lastname: Campbell
authors.forename: N
authors.initials: N
authors.lastname: Brautbar
mesh_terms: D000328:Adult; D003692:Delayed-Action Preparations; D004343:Drug Implants / Q000009:adverse effects*; D004700:Endocrine System Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000209:etiology*; D016912:Levonorgestrel / Q000009:adverse effects* / Q000276:immunology; D011374:Progesterone / Q000009:adverse effects; D012828:Silicones / Q000009:adverse effects*; D014116:Toxicology / Q000379:methods
chemical_list: D003692:Delayed-Action Preparations; D004343:Drug Implants; D012828:Silicones; D011374:Progesterone; D016912:Levonorgestrel