HUMAN ADJUVANT DISEASE - PRESENTATION AS A MULTIPLE SCLEROSIS-LIKE SYNDROME

Twenty-six women had a systemic disease with central nervous system (C NS) involvement at a mean age of 39.2 years (range, 23 to 64 years) af ter receiving silicone breast implants (n = 25) or silicone fluid inje ctions into breasts (n = 1). The median latency period between breast surgery and onset of symptoms was 5.71 years (range, 3 months to 15 ye ars). All patients had evidence of disseminated CNS lesions; 20 patien ts also had evidence of peripheral neuropathy. Additional problems inc luded myalgia (n = 24), joint stiffness (n = 23), arthralgia (n = 22), sicca complex (dry eyes and dry mouth) (n = 19), headache (n = 16), s kin rash (n = 15), joint swelling (n = 14), Raynaud's phenomena (n = 1 4), fever (n = 13), hair loss (n = 12), allergies (n = 11), sensitivit y to sunlight (n = 10), and lymphadenopathy (n = 9). Magnetic resonanc e imaging brain scans were abnormal in 22 of 26 patients (21, white ma tter lesions; 1, ischemic lesions; 4, cerebral atrophy). Spinal tap re vealed oligoclonal bands in 18 of 23 patients. Visual evoked responses were delayed in 14 of 23 patients, and autodirected antibodies were d etected in 16 of 26. Sural nerve biopsy results showed loss of myelina ted fibers in 15 of 15. Seventeen of 24 patients (71%) who had implant removal were found to have grossly ruptured implants. We believe our patients had a new syndrome triggered by the foreign material in their body. This syndrome appears as a systemic inflammatory autoimmune dis ease with central nervous system involvement resembling multiple scler osis.