Field T, Bridges A J
Department of Medicine, University of Wisconsin Hospital, Madison 53792, USA.
Curr Top Microbiol Immunol. 1996;210:283-90. doi: 10.1007/978-3-642-85226-8_29.
We reviewed the available clinical and laboratory data from 56 patients with scleroderma and silicone implants from the English medical literature and 19 cases which have not been previously reported. The average age of onset of scleroderma was 43.6 +/- 10 years (range 20-73). Patients had silicone implants for an average of 9 +/- 4 years prior to the development of scleroderma (range 1-32). Most patients had limited scleroderma (41%). Twenty three percent had intermediate scleroderma and 36% had diffuse scleroderma. Clinical findings included: Raynaud's phenomenon in 77%, esophageal dysfunction in 53%, and pulmonary involvement in 47%. Cardiac and renal involvement were uncommon. Antinuclear antibodies by immunofluorescence were found in 83 percent of patients. The immunofluorescence pattern was speckled in 53%, centromere in 31% and nucleolar in 9%. Other antibodies (Scl-70, RNP, SSA/Ro, PM-Scl) were found in only a small proportion of patients. A clinical, serologic and immunogenetic comparison of patients with silicone implants and scleroderma and patients with idiopathic scleroderma is needed to better understand the pathogenesis of this disorder.
我们回顾了从英文医学文献中获取的56例患有硬皮病且植入了硅胶的患者以及19例此前未报告病例的临床和实验室数据。硬皮病的平均发病年龄为43.6±10岁（范围20 - 73岁）。患者在硬皮病发病前平均植入硅胶9±4年（范围1 - 32年）。大多数患者患有局限性硬皮病（41%）。23%患有中间型硬皮病，36%患有弥漫性硬皮病。临床症状包括：77%的患者有雷诺现象，53%有食管功能障碍，47%有肺部受累。心脏和肾脏受累不常见。83%的患者通过免疫荧光法检测到抗核抗体。免疫荧光模式呈斑点状的占53%，着丝点型占31%，核仁型占9%。仅一小部分患者发现有其他抗体（Scl - 70、RNP、SSA/Ro、PM - Scl）。为了更好地理解这种疾病的发病机制，需要对植入硅胶且患有硬皮病的患者与特发性硬皮病患者进行临床、血清学和免疫遗传学比较。
