title: Severe ASIA syndrome associated with lymph node, thoracic, and pulmonary silicone infiltration following breast implant rupture: experience with four cases.
abstract: Silicone has been considered biologically inert; thus it has been employed in many medical devices and nowadays is commonly used in plastic surgery for mammary prosthesis. It is well tolerated in most cases. However, autoimmune disorders and siliconomas with granulomatous reactions after silicone implant rupture have been described. We report cases of four women who developed systemic disorders following rupture of silicone breast implants resulting in lymph node and thoracic silicone infiltration. The symptoms in these cases, including arthralgia, myalgia, generalized weakness, severe fatigue, sleeping disturbances, cognitive impairment, memory loss, irritable bowel syndrome, and weight loss, clearly match the criteria of the recently defined autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
authors: Department of Internal Medicine A, Shaare Zedek Medical Center and the Hebrew University Medical School, Jerusalem, Israel nesher@inter.net.il.
authors: G
authors: G
authors: Nesher
authors: Department of Clinical Medicine and Rheumatology, Campus Bio-Medico University, Rome, Italy.
authors: A
authors: A
authors: Soriano
authors: Department of Internal Medicine, Sheba Medical Center, Tel Hashomer, Israel.
authors: G
authors: G
authors: Shlomai
authors: Department of Internal Medicine, Hasharon Hospital - Rabin Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel.
authors: Y
authors: Y
authors: Iadgarov
authors: The Pulmonary Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors: T R
authors: TR
authors: Shulimzon
authors: Department of Internal Medicine, Division of Rheumatology, University of Padova, Italy.
authors: E
authors: E
authors: Borella
authors: Department of Internal Medicine, Hasharon Hospital - Rabin Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel.
authors: D
authors: D
authors: Dicker
authors: Sackler School of Medicine, Tel Aviv University, Israel The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Israel.
authors: Y
authors: Y
authors: Shoenfeld
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000276:immunology*; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006099:Granuloma / Q000139:chemically induced / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011475:Prosthesis Failure; D012828:Silicones / Q000009:adverse effects*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
chemical_list: D000277:Adjuvants, Pharmaceutic; D012828:Silicones
keywords: ASIA syndrome; Musculoskeletal disease; autoimmunity; fatigue; silicone implantation