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Silicone filings in macrophages of viscera: an iatrogenic complication of haemodialysis.

In seven long-term dialysis patients, autopsy material showed varying amount of refractile foreign material in macrophages and giant cells of lung, liver, spleen, bone marrow, skin, thoracic and abdominal lymph nodes, but not in brain, heart, kidney or endocrine organs. Electron microscopy showed its presence within lysosomal membranes of macrophages. Such material was also demonstrable in liver biopsies of patients dialysed for only several months. Possible clinical consequences were hepatosplenomegaly, elevation of transaminases, hypersplenism with pancytopenia and possibly bile duct carcinoma. SEM with X-ray fluorescence showed particles within spleen and liver cells with a characteristic Si K alpha 2.09 kev peak. Identical material was found as fillings on silicone tubing exposed to roller pumps.