Learning Point for Clinicians

A number of studies have associated silicone breast implants with the development of connect-ive tissue diseases. However, the role of free silicone gel in relation to idiopathic or typical con-nective tissue disease is not clear. This is the first case report of scleroderma-induced pulmonary hypertension following ruptured silicone implants. Case description A 71-year-old Iranian lady presented in 1998 with progressive dry cough, breathlessness, dysphagia, myalgia, blurred vision and Raynaud’s for 3 years. She had widespread skin pigmentation, sclerodac-tyly, acutely raised Creatine Kinase (CK) of 2000 after simvastatin therapy but normal muscle strength. In 2011, she became more breathless on exertion and reduced exercise tolerance of 20 yards. Past medical History She had silicone breast implants inserted in 1977. During a routine mammogram in 1992, her implants ruptured and both implants were removed in 1994