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.

Two healthy boys, ages 4 and 7, had their silicone testicular implants electively removed because of parental concern. Examination of one implant demonstrated significant granular mural small vessel staining with antisera to IgM and C1, mild staining with anti-IgG, and minimal staining with anti-IgA and C3 in the fibromuscular tissue around the implant. In the other specimen, there was prominent vascular wall staining with antisera to C1, without co-deposits of immunoglobulins. These observations, although limited, suggest that silicone implants at sites other than the breast in children induce immunologic reactivity and could increase the risk for development of autoimmune disease.