Question:
Study for your perusal supplied by Barbara Hasenour.

(Interstitial pneumonia associated with human adjuvant disease, whichdeveloped 30 years after silicone augmentation mammoplasty).

Author: Mijata Y; Okano R; KuratomiAddress: Department of General Internal Medicine' Omiya Medical Center'Jichi Medical School. F1p4

Source: Nippon Kyobu Shikkan Gakkai Zasshi, 35:1093-8, 1997 Oct

ABSTRACT:

A 51- year-old woman was admitted to our hospital which exertional dyspnea'swelling and stiffness in her fingers. Raynaud's phenomenon and mammaryand axillary lymphadenopathy. She had received silicone augmentationmammoplasty 30 years ago' and had since noticed bilateral mammary andaxillary lymphadenopathy that was stable in size. In the years beforeadmittance she had become aware of an exacerbation of the lymphadenopathyand had begun to experience exertional dyspnea several months beforeadmission suggesting connective tissue disease. Physical examinationrevealed symmetrical weakness of the proximal and a differential diagnosisof polymyosistis or sjorgren's syndrome was made. Axillary lymph nodebiopsy findings were consistent with silicone lumphadenitis. In addition,chest roentgenogram and HRCT (elevated total cell count and neutrophil andeosinophil fractions) and transbronchial lung biopsy specimens (unevenlydistributed alveolitis with fibrosis) indicated concurrent interstitialpneumonia. The clinical correlation between exacerbation of siliconelymphadenopathy and the development of connective tissue disease withaccompanying interstitial pneumonia strongly suggest human adjuvant disease(HAD) as the pathogenesis. To our knowledge interstitial pneumoniaassociated with HAD is rare.

Answer: For those of us with these lung diseases, it is hell because thetreatments currently being used, seldom work for us and often againstus. here is the studies currently under way or enrolling at TheNational Jewish Medical and Research Center: (This appears to be a bitoutdated, but you might be able to get information by writing to themconcerning the outcomes. I also wonder if it might not be worth whileto try and get into some of the available trials and let them"discover" the silicone connection, in order to get some kind ofattention )

Kathi

ILD PROGRAM CLINICAL TRIALS

Current Trials for Idiopathic Pulmonary Fibrosis (IPF):

"Specialized Center of Research" Immunologic Regulation of PulmonaryFibrosis: We are currently enrolling patients with open lung orthorascopic biopsy proven Idiopathic Pulmonary Fibrosis into theSpecialized Center of Research for Idiopathic Pulmonary Fibrosis,sponsored by the National Institutes of Health. The initial evaluationat National Jewish and follow-up would be provided free to patientswho qualify for the study.

Treatment Trial, Interferon-beta: We are one of the lead centers ofthe 34 sites that have enrolled 167 patients into a randomized placebocontrolled treatment trial of interferon-beta. This clinical trial iscurrently closed to enrollment. Interferon-beta is a new therapeuticapproach in this devastating disease, we hope to have informationabout its usefulness approximately April of 2001. Patient evaluation,follow-up, and study medication are all provided free of charge to thepatient.

Treatment Trial, Interferon-gamma 1-b: We are currently enrollingpatients into a randomized, double-blind, placebo-controlled phase IIIstudy of the safety and efficacy of subcutaneous recombinantInterferon - g1b (rIFN-g 1b) in patients with Idiopathic PulmonaryFibrosis. This trial is sponsored by InterMune Pharmaceuticals and allstudy visits would be provided free to patients who qualifying for theenrollment.

Treatment Trial, IL-10: We will soon be enrolling patients into amulti-center, randomized, placebo-controlled trial of Tenovil(rHuIL-10) in patients with Idiopathic Pulmonary Fibrosis and NSIP.This trial is sponsored by Schering-Plough Research Institute and allstudy visits would be provided free to patients who qualifying for thestudy.

Other Treatment Trials Available for Idiopathic Pulmonary Fibrosis(IPF): In general, the response to our currently available therapyfor idiopathic pulmonary fibrosis (IPF) is much lower than we wouldlike. Because of this we are aggressively pursuing new approaches forthis disease. We anticipate another protocol of a novel inhaledtherapy available to newly diagnosed, untreated patients with IPFwithin the next 6 months.