We have previously reported the occurrence of severe SLE with nephritis in two children, a 15 year old boy in 1992, 12 years after a silicone testicular prosthesis was implanted in the scrotum for cosmetic reasons (unilateral cryptochordism) and a 10 year old girl in 1981, two years after a silicone scleral sponge was implanted in her eye (retinal detachment) (Lancet, 1994.343:354-5). 2/50 children who have had renal biopsies for lupus nephritis at our hospital between 1977-1993 have had silicone implants prior to their developing SLE.

We sent letters to the parents of 208 boys who had been implanted between 1977-1993, advising them of our concerns; none reported any rheumatologic disease. Forty-eight agreed to come for laboratory evaluations including ANA and anti-DNA antibodies. Ten of the 48 (20.8%) were ANA positive; none had anti-DNA antibodies. The frequency of ANA in 49 age/sex matched healthy controls was not significantly different from that of those who had been implanted. Two controls and 2 patients had antibodies detectable by Western Blotting; all were to an antigen of approximately 80 Kilodalton. If there is a causal relationship between silicone testicular implants and development of ANAs, it could be at a frequency that would require larger cohorts of implanted subjects and controls to demonstrate this feature. The frequency of ANA positivity in a population of healthy boys is approximately 16.3%. This frequency of ANA positivity has not previously been documented in children and this new information is an important side benefit of our research.