A clinical and immunologic evaluation of women with silicone breast implants and symptoms of rheumatic disease.
OBJECTIVE
To describe the clinical and serologic features of women with silicone breast implants who were referred for symptoms of rheumatic disease.


METHODS
A case series.


METHODS
University and private rheumatology practices.


METHODS
A total of 156 women with silicone breast implants and rheumatic disease complaints. Controls for the serologic studies included women with silicone implants and no rheumatic symptoms (n = 12) and women with fibromyalgia without silicone implants (n = 174).


METHODS
Complete physical examination and testing for immunoglobulins; complement; C-reactive protein; rheumatoid factor; and autoantibodies by indirect immunofluorescence, immunodiffusion, and Western blot.


RESULTS
Three subgroups of patients were defined based on clinical and laboratory findings: joint and muscle pain (n = 95), joint swelling (n = 32), and connective tissue disease (n = 29). Most women had normal immunologic studies. The patients with joint swelling had mild, asymmetric, rheumatoid-factor-negative synovitis that did not meet American College of Rheumatology criteria for rheumatoid arthritis. Fourteen patients had a scleroderma-like illness and anti-centromere or anti-PM-Sci antibodies by Western blot. Ten patients had a positive Western blot for BB' polypeptide, a small nuclear ribonucleoprotein (snRNP), but did not meet criteria for systemic lupus erythematosus. No autoantibodies to known disease-related polypeptides were detected on Western blot in the control groups.


CONCLUSIONS
Most women with silicone implants and rheumatic complaints had normal results of serologic tests and nonspecific symptoms, suggesting no serious connective tissue disease. However, a subset of women had clinical signs and serologic tests that were unusual even for referred patients. These observations suggest, but cannot establish, that some women with silicone breast implants may develop atypical immunologic reactions.
Bridges
A J
AJ
University of Missouri-Columbia.
Conley
C
C
Wang
G
G
Burns
D E
DE
Vasey
F B
FB
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D016022:Case-Control Studies; D003240:Connective Tissue Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000295:instrumentation*; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D012216:Rheumatic Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D012261:Ribonucleoproteins; D017411:Ribonucleoproteins, Small Nuclear / Q000276:immunology; D012828:Silicones / Q000009:adverse effects*; D055517:snRNP Core Proteins
D001323:Autoantibodies; D001324:Autoantigens; D012261:Ribonucleoproteins; D017411:Ribonucleoproteins, Small Nuclear; D012828:Silicones; D055517:snRNP Core Proteins