Reumatologia: pesquisas atuais
Acesso livre
ISSN: 2161-1149 (Printed)
ISSN: 2161-1149 (Printed)
Vera-Lastra O, Cruz-DomÃnguez MP, Medrado RamÃrez G, Medina G, Amigo MC, Peralta-Amaro AL, Gayosso-Rivera JA, Jara LJ
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.