MULTIPLE SCLEROSIS-LIKE SYNDROME
MULTIPLE SCLEROSIS-LIKE SYNDROME IN WOMEN WITH SILICONE
BREAST IMPLANTS: A NOVEL NEUROLOGICAL DISEASE WITH RHEUMATOLOGICAL SYMPTOMS.
Britta Ostermeyer Shoaib and Bernard M. Patten.
Houston, Tex 77030.
Twenty-six women developed a systemic disease with central
nervous system involvement at a mean age of 38 years (range 21-64
years) after receiving silicone breast implants (n=25) or fluid
injections into breasts (n=1). The medium latency period between
breast surgery and onset of symptoms was 5 years (range 3 months
- 15 years). All patients had evidence of disseminated central
nervous system lesions. Twenty patients also had evidence for
peripheral neruopathy. Additional problems included myalgia
(=24), joint s (n=23), arthralgia (n=22), Sicca complex (dry
eyes and dry mouth)(n=19), headache (n=16), skin rash (15), joint
swelling (n = 14), Raynaud's phenomena (n=14), fever (n=13), hair
loss (n=12), allergies (n=11), sensitivity to sunlight (n=10) and
lymphadenapathy (n=9). MRI of the brain was abnormal in 22/26
(21 white matter lesions,1 ischemic lesions, 4 cerebral atrophy).
Spinal tap revealed oligoclonal bands in 18/23. Visual evoked
responses were delayed in 14/23. Autodirected antibodies were
detected in 16/26. Sural nerve biopsy showed loss of myelinated
fibers in 15/15. Seventeen of 24 patients (71 %) who underwent
implant removal were found to have grossly ruptured implants. We
believe our patients developed a new syndrome triggered by the
foreign material in their body. This syndrome presents as a
systemic inflammatory autoimmune with central nervous system
involvement resembling February 9, 1996multiple sclerosis.