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 rapture 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 rapture 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 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.