Background The Autoimmune Syndrome Induced by Adjuvant (ASIA) includes several clinical conditions as siliconosis, gulf war syndrome, miofasciitis macrophagic syndrome and post vaccination phenomenon. Acting as an adjuvant the Breast implants (BI) could be potentially linked with several autoimmune diseases.
Objectives The purpose of this study was to describe the rheumatological characteristics of a group of patients with the history of previous BI, that assisted to a rheumatologist, and to compare them with age matched controls.
Methods A retrospective, descriptive study was designed. Patients with the history of BI, that assisted to a rheumatologist, where included. The data was collected from clinical registries, including socio-demographic data and comorbidities, kind and duration of symptoms, development of a specific rheumatologic syndrome/disease, fulfilment of ASIA proposed criteria and type of clinical evolution. All the patients and their controls attended private practice rheumatology outpatient clinics.
For each case, 2 controls were randomly selected from clinical registries if they had: ±2 years of age compared with the cases at the first visit, had no history of BI or pre-existing rheumatological disease and had attended at least 2 followup visits.
Statistical Analysis – Categorical data were expressed in frequency and percentage, continuous data in median and interquartile range (IQR). Chi2 and Fisher test were used to analyse categorical data and Student T test or Mann-Whitney for continuous data based in its distribution. A p value <0.05 was considered as significative.
Results Twenty-two female patients with history of BI (all met ASIA classification criteria) and 44 female controls were included. Median age was 44.5 years (IQR 38–53), without difference between groups (44.3 vs 44.9, p=0.8). The median time between the BI and the beginning of the rheumatologic symptoms was 4 years (IQR 1–10) since all the patients developed the symptoms after the BI surgery. The cases had significantly more frequency of arthritis (31.8% vs 11.4%, p=0.042), less myalgias (18.2% vs 75%, p<0.0001) and less fatigue (18.2% vs 47.7%, p=0.03) than the controls. Though it was not statistically significative, the group of patients had more frequency of specific rheumatic diseases (36.4% vs 19%, p=0.1), with more rheumatoid arthritis (13.6% vs 4.5%, p=0.1) and fibromyalgia (13.6% vs 9.1%, p=0.5) than controls. Overall, the frequency of any specific rheumatic disease (including fibromyalgia) was higher in patients than in controls (50% vs 29.5%, p=0.1).
Conclusions In our group of patients with history of BI we found more prevalence of arthritis, and less of myalgia and fatigue. Maybe arthritis could be a characteristic symptom of ASIA. The weaknesses of this study relies in its retrospective design and the small sample size. Prospective studies could be helpful to answer the question of the possible link between BI and rheumatic diseases.
Disclosure of Interest None declared