1992 Volume 15 Issue 1 Pages 75-80
A case of tubulo-interstitial nephritis and anterior uveitis after silicone augumentation mammoplasty was reported. The patient was 21-year-old woman and she has had left ocular pain and high grade fever which started one month ago and was diagnosed as bilateral anterior uveitis ophthalmologically. Blood tests revealed presence of inflammation with prominent elevation of serum CRP value and ESR and she was administered antibiotics and anti-inflammatory drugs for ten days before admission. She received silicone augmentation mammoplasty seven months before admission.
At admission, physical examinations revealed no particular findings except continuous low grade fever of 37°C. The results of blood tests were as follows; hematocrit 31.6%, WBC 7, 100, CRP 3.5mg/dl, ESR 100mm/hr and serum IgG 2, 085mg/dl. Chest CT showed a high density area between major and minor pectoral muscles consistent with the area of previous silicone implantation, although chest X-P showed no obvious findings. 67Gallium scintigraphy showed high accumulations at the site of silicone implantation, eyes and kidneys bilaterally.
We have suspected the silicone implantation as one of the major causes of the abnormal findings, and removed silicone surgically. One week after the removal, clinical and laboratory findings improved immediately. Furthermore, follow-up 67Gallium scintigraphy revealed prominent improvement. Renal biopsy was also performed and revealed presence of tubulo-interstitial nephritis.
This is an extremely rare case which we found no previous report, and supposed that, with immunological reaction, silicone augmentation mammoplasty may cause tubulo-interstitial nephritis and uveitis.
