PERIPHERAL-BLOOD EOSINOPHILIA, HYPERIMMUNOGLOBULINEMIA-A AND FATIGUE - POSSIBLE COMPLICATIONS FOLLOWING RUPTURE OF SILICONE BREAST IMPLANTS

Background: Silicone breast implantation has been considered quite saf e and of major cosmetic value. Immunologic sequelae such as collagen v ascular diseases have not been confirmed in large studies. Objective: We describe a 55-year-old woman who developed severe fatigue, peripher al blood eosinophilia, and hyperimmunoglobulinemia A after rupture of a silicone breast implant during closed manual manipulation to lyse fi brotic tissue. Methods: We charted evidence for eosinophilia over a 19 -year period and determined quantitative immunoglobulins, and lymphocy te subsets by FAGS analysis. Results: Peripheral eosinophilia in 1976 was 693/mm(3) and increased to 1360/mm(3) after rupture of the implant in 1992. Serum immunoglobulin A was 332 mg/dL in 1976 and ranged afte r rupture from 473 to 627 mg/dL without other cause, Fatigue was not r eversed with a parenteral corticosteroid injection. CD4 and CD8 subset s were normal but 40% of CD3 cells were Ia positive although not CD25 positive (IL2 receptor), Only 5% of B cells were CD19CD23 positive des pite the high concentration of serum IgA. Conclusion: This case is an example of a previously unreported apparent adverse effect of silicone -breast implant rupture with persisting eosinophilia, hyperimmunoglobu linemia A, and fatigue.