Objective. Recent evidence suggests that immunologic abnormalities are
not uncommon in individuals with silicone breast implants. The purpos
e of our study was to evaluate in a consecutive manner, the prevalence
of autoimmunity as assessed by the presence of antinuclear antibodies
in a larger number of patients with silicone breast implants. Methods
. Antinuclear antibody (ANA) testing using an indirect immunofluoresce
nce technique was performed on 813 individuals with silicone breast im
plants. All subjects except for 3 transsexual males, were female. The
overwhelming majority, over 99%, were white. The average age of the su
bjects was 46.2, with a range of 17 to 72 years. Results. ANA positivi
ty was found in 244 of 813 individuals (30%) using a mouse kidney subs
trate; and in 470 of 813 (57.8%) using a HEp-2 cell line. The most com
mon immunofluorescent pattern found using HEp-2 was speckled, present
in 341 (72.5%) individuals, followed by homogeneous pattern in 113 (24
%), nucleolar in 63 (13.4%), and 5 (1.06%) were anticentromere. Anti-d
sDNA antibodies measured by an ELISA assay were found in 6 of 71 patie
nts (8%). Rheumatoid factor and C-reactive protein were found above he
althy controls in less than 10% of cases studied. The high prevalence
of ANA found in patients with silicone breast implants agrees with sim
ilar observations by others. The finding of anticentromere and nucleol
ar patterns has great interest and relevance. These fairly distinct AN
A patterns are most commonly seen in the idiopathic form of scleroderm
a and related conditions. Conclusion. These findings suggest that ANA
positivity is relatively common in individuals with silicone breast im
plants, and may support the existence of autoimmune mechanisms in the
pathogenesis of the clinical manifestations seen in this population.