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Human adjuvant disease revisited: a review of eleven post-augmentation mammoplasty patients

  [ 140 votes ]   [ Discuss This Article ] • September 3, 1994

OBJECTIVES: We have reviewed 11 women post-augmentation mammoplasty
who were referred to our clinic with diffuse rheumatic
complaints. All patients had undergone mammoplasty with
silicone gel-filled implants prior to the onset of their
locomotor symptoms (mean latency time 7.8 years). One
physician interviewed and examined each of these patients
following a standardized format for clinical retrieval.

RESULTS: Of the patients reviewed, 6 patients had clinical
fibromyalgia based on the ACR criteria, and the remaining 5
patients had symptoms consistent with the "chronic fatigue
syndrome." None of our patients were found to have evidence of
a defined connective tissue disease. Antinuclear antibodies
were detected in 4 (36%) patients and low level titres of
extractable nuclear antigens in only 2 (18%).

CONCLUSIONS: Previously a causal relationship between
the use of silicone gel-filled breast implants and the
subsequent development of symptoms referred to as human
adjuvant disease (HAD) has been proposed. On the basis of
currently accepted criteria we have preferred to diagnose our
post-mammoplasty patients without specific connective tissue
disease, as having chronic fatigue syndrome (CFS), or when
tender points are present, as having fibromyalgia (FMS),
rather than implying that such cases represent a separate and
unique rheumatological disease entity. In the light of our
current understanding of CFS and FMS, a relationship between
them and the previous silicone mammoplasty seems possible.

Fenske TK, Davis P, Aaron SL

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