Still's-like disease, breast prosthesis, and collagen implants

Silicone-induced connective tissue disease raises a controversial issue. We report a case of Still's disease associated with silicone and collagen imp lants that showed improvement on steroids, but remained steroid-dependent d espite removal of the silicone implants. This observation complements four previous cases in the literature and questions the role of breast implants in the pathogenesis of Still's disease. The number of cases studied is insu fficient for conclusions. but silicone-implant-associated syndrome may be c onfused with Still's disease. We consequently propose the use of ferritinem ia and its serum glycosylated fraction level as discriminating factors. Col lagen has been associated with some inflammatory diseases, but never previo usly with Still's disease. However, considering this observation and previo us data in the literature, its role may be postulated as an exacerbating fa ctor or a pathogenic agent.