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Microscopic polyangiitis after silicone breast implantation
Masayuki Iyoda1, Jyun Ito, Hisako Nagai
1Department of Nephrology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan, iyoda@med.showa-u.ac.jp
Abstract:
We describe the case of a patient who developed microscopic polyangiitis (MPA) after silicone breast implantation. A 60-year-old woman who had undergone silicone breast implantation was admitted to our hospital with complaints of general malaise and hematoproteinuria. She was diagnosed as having MPA with evidence of acute progressive renal failure, pulmonary hemorrhage, and positivity for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA). A renal biopsy showed severe necrotizing and crescentic glomerulonephritis with arteriolitis. The patient received high-dose steroids and plasma exchange treatment, but died of progressive pulmonary hemorrhage and multiple cerebral hemorrhage. Silicone implantation is associated with scleroderma, systemic lupus erythematosus, and rheumatoid arthritis. This case report indicates the possibility of the development of MPA after silicone breast implantation.
Insights
This case report details a patient who developed microscopic polyangiitis (MPA) following silicone breast implants. The findings suggest a potential link between silicone implants and MPA development.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Silicone breast implantation is a common cosmetic procedure.
- Autoimmune diseases, including scleroderma, lupus, and rheumatoid arthritis, have been associated with silicone implants.
Observation:
- A 60-year-old woman presented with malaise and hematuria after silicone breast implantation.
- Clinical presentation included acute progressive renal failure and pulmonary hemorrhage.
Findings:
- Diagnosis of microscopic polyangiitis (MPA) was confirmed by positive myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA) and renal biopsy findings.
- Renal biopsy revealed severe necrotizing and crescentic glomerulonephritis with arteriolitis.
- Despite treatment with high-dose steroids and plasma exchange, the patient experienced fatal pulmonary and cerebral hemorrhages.
Implications:
- This case highlights a potential, previously unreported association between silicone breast implantation and the development of microscopic polyangiitis.
- Further research is warranted to investigate the potential etiological role of silicone implants in MPA pathogenesis.