HLA Typing in Women with Breast Implants

Young, V. Leroy; Nemecek, J R; Schwartz, Benjamin D.; Phelan, Daniel; Schorr, Marla Watson

doi:10.1097/00006534-199512000-00001

Cited by 47 publications

(14 citation statements)

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“…With regard to HLA subclass, out of these 42 %, 81 % were found to be DR53-positive. These findings suggest that DR53 may serve as a marker for women with HLA predisposition to develop silicone-induced ASIA [51]. Additional support is provided by the work of O'Hanlon et al in which HLA typing for DRB1 and DQA1 genes was compared between three patient groups: women who developed myositis after silicone implantation, healthy women with silicone implants, and women with idiopathic myositis who do not have silicone implants.…”

Section: Patients With History Of Allergic Conditions/atopic Disordersmentioning

confidence: 89%

Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?

2015

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Silicone implants have been in use since the mid-twentieth century, especially in the field of reconstructive breast surgery, and have long been considered as biologically inert and harmless. However, growing body of evidence from the past two decades links silicone with subsequent autoimmunity-related complications, collectively known as autoimmune/inflammatory syndrome induced by adjuvant--ASIA. Previous data suggest that while some patients tend to develop post-exposure autoimmune phenomena such as ASIA, other do not. However, thus far, no criteria for risk stratification were suggested. This current review summarizes the data linking silicone implants and autoimmunity, suggesting means of defining individuals who are at increased risk to develop silicone-induced ASIA, and therefore, a recommendation was made to avoid silicone implantation, e.g., individuals with previously diagnosed autoimmune disorders or with genetic preponderance for hyperactive immune system should not be considered as candidates for silicone implantation.

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Section: Patients With History Of Allergic Conditions/atopic Disordersmentioning

confidence: 89%

Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?

2015

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“…This would certainly explain the high number of false-positives reported in the literature [1,19,16] and also found in our studies. The most common mistake is to interpret those curved, hypointensive lines and structures within the implant, which produce a weak MRI signal, as linguine signs [4,14] and, by implication, consider them as evidence of intracapsular ruptures [29]. The literature distinguishes between intra-and extracapsular implant ruptures [9,22,28,27,24].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, an increasing number of research papers have been published that question -or even reject -the proposed relationships between local [25] and general symptoms attributed to silicone-induced adjuvant diseases [8,24,20,11]. Some research also suggests that only HLA-DR53 carriers are at risk of developing silicone-related medical problems [24,29]. Nevertheless, we would still recommend that damaged silicone implants should be identified and removed as early as possible, at least until such time as the true implications and risks associated with damaged implants are properly understood.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging to diagnose breast implant rupture

Wedler

Meuli‐Simmen

et al. 2002

European Journal of Plastic Surgery

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The purpose of this study was to prospectively evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) as a method to discover an implant rupture in patients with breast augmentation or reconstruction. From January 1997 to February 1998, 20 breast implants in 12 patients (mean age 52.5 years) were removed surgically. Indications included local pain after reconstructive breast surgery (n=5 patients), local deformities after breast augmentation (n=3) or with (n=3) pain, and secondary intervention after sex change (n=1). In all patients, MRI (T2-weighted as well as dynamic contrast-enhanced T1-weighted sequences) was performed prior to surgery. On MRI, hypointense curvilinear lines ("linguine sign") on T2-weighted images, interruption of the fibrous capsule, or the presence of siliconomas were judged indicative of implant rupture. The MRI findings were compared with the surgical findings in all cases. MRI suggested that 14 implants were ruptured, but intraoperative rupture was confirmed in 9 implants. MRI gave a false-negative result in one implant, but false-positive in 5 cases. Sensitivity of MRI for detection of implant rupture was 100%, specificity 88%. Early and focal contrast enhancement indicative of malignancy was not seen. Siliconomas were found as lumps in two cases without a precise conclusion preoperatively. MRI combined with the clinical symptoms is the most efficient method for the evaluation of breast implant conditions. It can facilitate the decision to perform surgical revision.Keywords Breast pathology · Breast disease diagnosis · Magnetic resonance imaging

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“…Young et al [26] have showed a higher incidence of HLA-DR53 and DQ2 among symptomatic breast implant women. Morse et al [27] found in nine patients with scleroderma and silicone breast implants a higher frequency of Glycine or Tyrosine in position 26 at the hyper-variable first domain of HLA-DQB1 instead of Lysine.…”

Section: Legal Issues Of Silicone Brest Implantsmentioning

confidence: 97%

Silicone Gel Breast Implants and Connective Tissue Disease—A Comprehensive Review

Bar-Meir

Eherenfeld

Shoenfeld³

2003

Autoimmunity

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Silicone breast implants have been in use for breast reconstruction and breast augmentation for a long time. In the late 80's anecdotal reports describing a possible association between silicone-gel filled breast implants, and autoimmune diseases was accumulating. Due to the growing concern about the safety of silicone-gel implants, the Food and Drug administration (FDA) restricted their use to participants in controlled clinical trials, including women having reconstructive surgery. However, in recent years, large meta-analyses were unable to establish an association between silicone-gel breast implants and autoimmune disease. We review the current literature, emphasizing the most important epidemiologic studies.

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HLA Typing in Women with Breast Implants

Cited by 47 publications

References 0 publications

Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?

Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) evolution after silicone implants. Who is at risk?

Magnetic resonance imaging to diagnose breast implant rupture

Silicone Gel Breast Implants and Connective Tissue Disease—A Comprehensive Review

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