Sclerodermalike esophageal disease in children breast-fed by mothers with silicone breast implants
J. J. Levine and N. T. Ilowite
Division of Pediatric Gastroenterology, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11042.
OBJECTIVE--To determine whether breast-fed children of mothers with
silicone implants are at increased risk for the development of
sclerodermalike esophageal involvement compared with children not exposed
to silicone implants. DESIGN--Case-series [corrected].
SETTING--Referral-based pediatric gastroenterology clinic. PATIENTS--Eleven
children (mean age, 6.0 years; range, 1.5 to 13 years; six boys and five
girls) referred for abdominal pain who were born to mothers who had
silicone breast implants (eight breast-fed children and three bottle-fed)
were compared with 17 patients (mean age, 10.7 years; range, 2 to 18 years;
11 boys and six girls) with abdominal pain who were not exposed to silicone
implants. METHODS--All children underwent esophageal manometry and upper
intestinal endoscopy with esophageal biopsy and were tested for antinuclear
antibody and autoantibodies to Scl-70, centromere, ribonucleoprotein, Sm,
Ro, La, and phospholipid. RESULTS--Six of the eight breast-fed children
from mothers with silicone implants had significantly abnormal esophageal
motility with nearly absent peristalsis in the distal two thirds of the
esophagus and decreased lower sphincter pressure. Upper esophageal
pressures and motility were normal. Compared with controls, the breast-fed
children had significantly decreased lower sphincter pressure and abnormal
esophageal wave propagation. These manometric abnormalities were not seen
in the three bottle-fed children. There was no difference in the expression
of autoantibodies in the breast-fed children compared with the bottle-fed
children or controls. CONCLUSIONS--A relationship appears to exist between
breast-feeding by mothers with silicone implants and abnormal esophageal
motility. Studies evaluating larger numbers of children are needed to
determine the extent of the risk.
