Scleroderma Information » Scleroderma » Silicone mammary implants and connective tissue disease.

Question:

Title: Silicone mammary implants and connective tissue disease.  Title Abreviation: Scand J Plast Reconstr  Surg Hand Surg                                Date of Pub: 1993 Dec  Author: Elberg JJ; Kjoller KH; Krag C;  Issue/Part/Supplement: 4     Volume Issue: 27  Pagination: 243-8  MESH Headings: Adult; Connective Tissue Diseases (*ET); Female; Human;  Implants, Artificial (*AE); Mammaplasty (*); Middle Age; Raynaud’s Disease  (ET); Scleroderma, Systemic (ET); Silicones (*AE); Synovitis (ET); -RN-;  Journal Title Code: UDN      Publication Type: JOURNAL ARTICLE  Date of Entry: 940516N       Entry Month: 9407  Country: SWEDEN              Index Priority: 2  Language: Eng                Unique Identifier: 94212088  Unique Identifier: 94212088  ISSN: 0284-4311  Abstract: The American Food and Drug Administration recently restricted  the use of silicone gel-filled mammary implants for breast augmentations  and reconstructions because a number of case reports had suggested that  there was an association between silicone and connective tissue disease.  We have found 36 such case reports published since 1982. Systemic  sclerosis is the most common reported diagnosis (n = 15). Implants were  removed from 15 patients, in nine of whom symptoms improved. The mechanism  behind the postulated relationship is obscure, and most authors focused on  an auto-immune-like response to silicone, which acts directly as a hapten  or as an adjuvant. We found no conclusive evidence to implicate silicone  mammary implants in connective tissue diseases. We do, however, recommend  removal of implants from patients with severe connective tissue diseases.  Patients with symptoms or active connective tissue disease should not be  considered for silicone implants.  Address: Department of Plastic Surgery, Copenhagen University Hospital,  Herlev, Denmark.  Number of References: 32

Response:

We found no conclusive evidence to implicate silicone  mammary implants in connective tissue diseases. We do, however, recommend  removal of implants from patients with severe connective tissue diseases.

Sounds like a paper written by a committee. The second statement does not follow from the first and in fact appears to repudiate it. Ed Ed Uthman, MD <http://www.neosoft.com/~uthman/   corpore servit." Pathologist                                    -Seneca Houston/Richmond, Texas, USA                

Response:

Title: Silicone mammary implants and connective tissue disease.  Title Abreviation: Scand J Plast Reconstr  Surg Hand Surg                                Date of Pub: 1993 Dec  Author: Elberg JJ; Kjoller KH; Krag C;  Issue/Part/Supplement: 4     Volume Issue: 27  Pagination: 243-8  MESH Headings: Adult; Connective Tissue Diseases (*ET); Female; Human;  Implants, Artificial (*AE); Mammaplasty (*); Middle Age; Raynaud’s Disease  (ET); Scleroderma, Systemic (ET); Silicones (*AE); Synovitis (ET); -RN-;  Journal Title Code: UDN      Publication Type: JOURNAL ARTICLE  Date of Entry: 940516N       Entry Month: 9407  Country: SWEDEN              Index Priority: 2  Language: Eng                Unique Identifier: 94212088  Unique Identifier: 94212088  ISSN: 0284-4311  Abstract: The American Food and Drug Administration recently restricted  the use of silicone gel-filled mammary implants for breast augmentations  and reconstructions because a number of case reports had suggested that  there was an association between silicone and connective tissue disease.  We have found 36 such case reports published since 1982. Systemic  sclerosis is the most common reported diagnosis (n = 15). Implants were  removed from 15 patients, in nine of whom symptoms improved. The mechanism  behind the postulated relationship is obscure, and most authors focused on  an auto-immune-like response to silicone, which acts directly as a hapten  or as an adjuvant. We found no conclusive evidence to implicate silicone  mammary implants in connective tissue diseases. We do, however, recommend  removal of implants from patients with severe connective tissue diseases.  Patients with symptoms or active connective tissue disease should not be  considered for silicone implants.  Address: Department of Plastic Surgery, Copenhagen University Hospital,  Herlev, Denmark.  Number of References: 32

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