009 - CELL GIANT ARTERITIS ASSOCIATED PULMONARY ISOLATED SARCOID GRANULOMA IN A 60 YEARS OLD WOMAN WITH BILATERAL SILICONE BREAST IMPLANTS (ID 844)
Abstract
Background and Aims
Auto-immune and systemic vasculitis disease associated with Silicon Breast Implant as part of the Autoimmune/Inflammatory Syndrome spectrum Induced by Adjuvants (ASIA) has been widely discussed. We report a rare case of 60 years old female with bilateral silicone breast implants who presented bronchial hyperresponsiveness, pulmonary isolated sarcoid granuloma, and cell giant arteritis.
Methods
A 60-year-old female patient with silicone breast implantation for cosmetic reasons at 42 years old, who presented five years after a history of dry cough, intense asthenia, and bronchial hyper responsiveness in pulmonary functions test and isolated pulmonary nodule in chest CT scan, for wich biopsy revealed non-caseating epitheloid granulomas with negative culture for mycobacteria or other infection. Laboratory workup showed a positive FAN 1/160, isolated positive anti-cardiolipin antibodies, without any other abnormality or argument for sarcoidosis or connective tissue disease.
Three years later, she was admitted with an intense headache, intermittent claudication of the jaw, and biological inflamatory syndrome. A pet scan showed a diffuse aortitis, and a temporal artery biopsy diagnosed cell giant arteritis. Kidney function was normal, negative proteinuria, and ANCA MPO and PR3 tests were repeatedly negative.
Results
The patient was put on corticosteroid treatment at doses of 0.7 mg/kg by day with a good improvement than relayed by methotrexate at 12.5 mg by week. Headache and weakness resolved, and the inflammatory test values decreased.
Conclusions
This case report raises the possibility of the development of cell giant arteritis and atypical pulmonary symptoms like bronchial hyperresponsiveness and isolated sarcoid granuloma after silicone exposure from breast implantation.
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