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.