AUTOIMMUNE REACTIONS IN PATIENTS WITH SILICONE BREAST IMPLANTS

Silicone breast implants have been surgical routine for over 30 years. An association between silicone augmentation and immune related disea ses has been reported in approximately 100 cases. In a retrospective s ingle center study we investigated 36 non-selected women with silicone breast implants and 36 sex- and age-matched controls. Autoimmune reac tions were evaluated by measuring antinuclear antibodies (ANA), rheuma toid factor (RF) and thyroid gland antibodies (TMS), along with angiot ensin-converting enzyme (ACE), C-reactive protein (CRP) and other immu nological and laboratory parameters. In the controls only 3 (8%) women had an elevated ANA titer and 1 demonstrated thyroid autoantibodies ( microsomal), giving a total of 4 (11%) women with detectable autoantib odies. By contrast, 12 (33%) of the 36 women with silicone augmentatio n had raised ANA titers (greater than or equal to 1 : 80), a significa ntly higher percentage than in the control group (p < 0.02). Of the 12 women, 1 showed antismooth muscle antibodies (ASMA; titer 1 : 40) and 2 of the patients displayed antineutrophilic cytoplasm antibodies (AN CA; 1 : 320 and 1 : 40, respectively), one of the latter also being po sitive for rheumatoid factor. 2 further women demonstrated thyroid aut oantibodies (microsomal), giving a total of 14 (39%) women in whom sig nificant autoantibodies were detectable. Clinical symptoms (musculoske letal) were present in 1 patient. Most of the observed autoantibodies were organ-unspecific, with a predominance of elevated ANA titers of t he heterogeneous type and not related to a distinct clinical entity. H owever, none of the investigated women with silicone breast implants s howed clinical symptoms or signs of connective tissue disease accordin g to ARA criteria.