Peripheral blood eosinophilia, hyperimmunoglobulinemia A and fatigue: possible complications following rupture of silicone breast implants.

BACKGROUND: Silicone breast implantation has been considered quite safe and of major cosmetic value. Immunologic sequelae such as collagen vascular diseases have not been confirmed in large studies. OBJECTIVE: We describe a 55-year-old woman who developed severe fatigue, peripheral blood eosinophilia, and hyperimmunoglobulinemia A after rupture of a silicone breast implant during closed manual manipulation to lyse fibrotic tissue. METHODS: We charted evidence for eosinophilia over a 19-year period and determined quantitative immunoglobulins, and lymphocyte subsets by FACS analysis. RESULTS: Peripheral eosinophilia in 1976 was 693/mm3 and increased to 1360/mm3 after rupture of the implant in 1992. Serum immunoglobulin A was 332 mg/dL in 1976 and ranged after rupture from 473 to 627 mg/dL without other cause. Fatigue was not reversed with a parenteral corticosteroid injection. CD4 and CD8 subsets were normal but 40% of CD3 cells were Ia positive although not CD25 positive (IL2 receptor). Only 5% of B cells were CD19 CD23 positive despite 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, hyperimmunoglobulinemia A, and fatigue.

Health effects of silicon tetrachloride. Report of an urban accident.

A spill of silicon tetrachloride (SiCl4) at a chemical plant caused the evacuation of several thousand people from an industrial park; 28 persons sought medical attention. Most of the affected individuals suffered only transient eye and upper airway irritation. Six of the plant employees were later referred for detailed evaluation of possible lung injury, but no definite evidence of SiCl4-induced pulmonary dysfunction was found. Five of these workers also experienced recurrent headaches, and two complained of pedal dysesthesias after the accident. Although the temporal relationship between the exposure and onset of these symptoms is notable, no definite etiologic relationship could be established.

[Pathomorphologic changes in the organs of rats following chronic inhalation exposure to liquid polyethylsiloxane]. / Patomorfologicheskie izmeneniia v organakh krys pri khronicheskom ingaliatsionnom vozdeistvii poliétilsiloksanovoi zhidkosti

A chronic 90-day inhalation of polyethylsiloxane fluid at a concentration of 10 and 2 mg/m3 produced local irritation and general toxic effect on rats. Local irritation induced catarrhal-desqueamative tracheitis that was accompanied by a microfocal interstitial process in the lungs. The general toxic effect gave rise to interstitial myocarditis that was followed by focal cardiosclerosis and dystrophic lesions of vascular walls and areas of liver parenchyma. Changes in the thymus-lymph system and adrenal structure suggested prolonged protective tension of the animal body. A chronic 90-day inhalation of polyethylsiloxane at a concentration of 0.2 mg/m3 brought about no pathological lesions in the microstructure of animal organs.

Toxicological problems with the REDY system.

Dialysate from the REDY dialysis system was examined for toxic elements, special attention being paid to the content of zirconium and aluminium. Also investigated was the concentration of formaldehyde in the rinsing fluid of three consecutive washings. The amount of zirconium and aluminium found in the dialysate was negligible. The concentration of formaldehyde was alarmingly high after two consecutive washings, a considerable amount (less than 50 mg) still remaining after three washings. It is recommended that at least three consecutive washings be performed, and that, if possible, formaldehyde be substituted by another antiseptic. Of special interest was the finding of a very high concentration of boron in the dialysate. It is suggested that this metal, which is a potentially toxic substance, may emanate from the patient. It is concluded that use of the REDY system carries no obvious toxicological risk.