Autoimmune/Inflammatory Syndrome Induced by Silicone Breast Implant and Risk Factors Associated to Autoimmune Diseases

Abstract

Autoimmune Rheumatic Diseases (ARD) have been associated with Silicon Breast Implant (SBI) as part of the spectrum of Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA). Silicone is an adjuvant that may bleed and subsequently may be a chronic stimulus to the immune system. Objective: To determine the prevalence of autoimmune diseases (AID) and risk factors associated to patients with ASIA induced by SBI (ASIA-SBI). Patients and methods: This study was performed between 2012 and 2018, in a tertiary referral center, from a cohort of 210 patients with ASIA. We selected those patients with ASIA-SBI and clinical manifestations of any ARD. We investigated family history of AID, smoking, allergies and comorbidities. Statistical analysis: Chi square and Odds Ratio (OR). Results: There were 45 women with current age 50 (29-75) years, mean time of appearance of clinical manifestations after SBI was 8.8 ± 5.5 years. We found systemic sclerosis (SSc) 10 patients, rheumatoid arthritis (RA) 8, undifferentiated connective tissue syndrome (UCTDS) 6, fibromyalgia (FM) 5, systemic lupus erythematosus (SLE) 4, Sjogren syndrome (SS) 3, angioedema/urticaria 3, overlap syndrome 2, and one of each of the following: Takayasu arteritis, Still disease, tunnel carpal syndrome and antiphospholipid syndrome. We observed family history of ARD 42%, allergy history 37.5% and smoking 35.5%. In ASIA-SBI patients, family history and smoking had a significant association with SSc OR 6.0 (CI 1.2-29), p<0.02 and RA OR 7.1 (CI 1.3-37.2), p<0.022. Conclusions: In patients with ASIA-SBI, family history of AID and smoking were associated with SSc and RA. In addition to SBI, environmental and genetic factors should be taken into account for the development of AID.