Annals of Occupational and Environmental Medicine

Diagnosis of perinuclear anti-neutrophil cytoplasmic antibody-associated microscopic polyangiitis in silicotics: case report: Ji-Won Lee, Jun-Pyo Myong, Yeong-Jin Choi, Seyoung Lee, Bum Seak Jo, Jung-Wan Koo; Ann Occup Environ Med 2016;28:21. Published online May 14, 2016; DOI: https://doi.org/10.1186/s40557-016-0108-1

Background

An association between silica exposure and autoimmune diseases including rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis has been made.

Case presentation

A 56-year-old male presented with silicosis and had an occupational history of precious metal processing for 30 years and a 30 pack-year smoking history. The patient was diagnosed with pneumoconiosis and received compensation. No other complications were reported for pneumoconiosis. The patient suddenly presented with a non-specific headache for several days and microscopic hematuria was identified upon examination in the outpatient clinic. Following several weeks, the patient presented with aggravated dyspnea and hemoptysis, and his Modification of Diet in Renal Disease estimated glomerular filtration rate indicated acute kidney injury. Diagnostic analysis revealed perinuclear ANCA-associated microscopic polyangiitis (p-ANCA-associated MPA).

Conclusion

Exposure to silica dust was likely one of the cause of p-ANCA-associated MPA. Possible pathogenic mechanisms of autoimmune diseases in silicotics and emphasis of the necessity for early diagnosis are discussed.

Citations

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Occupational Silica Exposure as a Potential Risk for Microscopic Polyangiitis
Alper Alp, Melike Ersoy, İbrahim Meteoğlu, Nesibe Kahraman Çetin, Hakan Akdam, Yavuz Yeniçerioğlu
Wilderness & Environmental Medicine.2023; 34(4): 543. CrossRef
Renal involvement in a silicosis patient – case report and literature review
Fei-Fei Chen, Hai-Yan Tang, Feng Yu, Cheng-Li Que, Fu-de Zhou, Su-Xia Wang, Guang-Fa Wang, Ming-Hui Zhao
Renal Failure.2019; 41(1): 1045. CrossRef
IL-10-Producing B Cells Suppress Effector T Cells Activation and Promote Regulatory T Cells in Crystalline Silica-Induced Inflammatory Response In Vitro
Yiping Lu, Fangwei Liu, Chao Li, Ying Chen, Dong Weng, Jie Chen
Mediators of Inflammation.2017; 2017: 1. CrossRef

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A Case of Complicated Silicosis with a Complex Clinical Course in a Glass Manufacturing Worker: Hee-Seok Yang, Jung-Il Kim, Byeong-Jin Ye, Tae-Jun Yoo, Sun-Woo Lee, Kap-Yeol Jung; Ann Occup Environ Med 2014;26:10-10. Published online May 15, 2014; DOI: https://doi.org/10.1186/2052-4374-26-10

Abstract PDF PubReader ePub

We reported a case of complicated silicosis that occurred in a glass manufacturing plant worker who had presumably been exposed to low-concentration free silica for almost 20 years. To the best of our knowledge this report is the first in the Republic of Korea. The physician’s first impression was cancer since the enlargement of neck and supraclavicuar lymph nodes had clearly progressed and metastasis was suspected in ultrasonography. However, it turned out to be reactive hyperplasia and anthracosis. Although lung cancer was suspected and tests were performed in 2 hospitals due to repetitive cough and dyspnea, along with weight loss of approximately 10% over the course of 7 months, the patient was eventually diagnosed with complicated silicosis and pneumothorax occurred after 1 year. Herein, we report this case with a literature review.

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Silicosis: enlarged cervical lymph nodes, pericardial effusion and lung abnormalities
H Li, M Cao, A Feng, H Cai
Occupational Medicine.2022; 72(6): 415. CrossRef
Impact of Working environment on Psychological Well-being in Male Baby boomers
Min-Jeong Park, Hyeong-seon Kim
Journal of Korean Public Health Nursing.2016; 30(1): 17. CrossRef
The Relationship between Job Stress and Organizational Effectiveness for Office Workers
Yoo-Mi Chae, Jeong-bae Rhie, Sook Lee
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(7): 389. CrossRef

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A Case of Sarcoidosis in a Stonemason Exposed to Crystalline Silica: Young Seung Cho, Kyeong Yeon Kim, Hyoung Gyu Yoon, Jung Wan Koo; Korean Journal of Occupational and Environmental Medicine 2012;24(2):189-194. Published online June 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.2.189

Abstract PDF: BACKGROUND
Sarcoidosis is a systemic granulomatous disease that can affect any organ, the exact cause of which is uncertain. Currently, investigations of crystalline silica improve the mechanism how it works the course of autoimmune diseases and some hypothesis supports that it also can attribute to sarcoidosis.
CASE
REPORT: The patient was a 53-year-old male, who works as a stonemason for 30 years. Sarcoidosis was suspected based on his chest X-ray and CT(Computed tomography). A biopsy was performed and he was indeed diagnosed with sarcoidosis.
CONCLUSION
It is thought that sarcoidosis is more prevalent in the people who work at places with a risk of exposure to crystalline silica. This case suggests that if a patient gets sarcoidosis after being exposed to crystalline silica, or after once being diagnosed with silicosis, his or her sarcoidosis may have occurred due to exposure to crystalline silica.

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A Case of Silicosis and Pneumothorax in a Workplace Producing Dental Porcerlain: Youngjoong Kang, Won Jun Choi, Sang Yun Lee, Jong Wan Yun, Hyung Sik Kim, Jong Uk Won, Sang Hwan Han; Korean Journal of Occupational and Environmental Medicine 2010;22(1):58-63. Published online March 31, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.1.58

Abstract PDF: BACKGROUND
Silicosis is more likely to occur in people working in the mining industry. However, workers suffering from silicosis have recently been reported frequently in other areas. We present a case of silicosis occuring in a 43-year-old man who had worked for 20 years in a workplace producing dental porcelain.
CASE
The man was admitted to the emergency room with acute chest pain caused by pneumothorax. Chest X-ray indicated numerous small opacities spread over the whole lung field and a large opacity in the right middle lung field. According to ILO classification, the shape of the small opacities was t/s, the profusion rate was 2/3 and the large opacity was classified into the B category. Following this diagnosis of silicosis, the patient's medical history and work exposure history were examined. According to his medical history, he had undergone closed thoracostomy in 2006 because he had suffered pneumothorax twice (in 2005 and 2006) and his smoking history was 7 pack years. In particular, he had been exposed to silica dust for 20 years in his workplace.
CONCLUSION
Despite the absence of any specific risk factor that caused pneumothorax, the patient suffered this condition three times. All clinical results and the progress of his physical symptoms, including radiologic findings from chest X-ray and computed tomography, clearly supported the diagnosis of silicosis. Except for exposure to silica dust in the workplace, no other risk factors causing silicosis were found. Therefore, he was finally diagnosed as having silicosis caused by exposure to silica dust in the workplace and followed by pneumothorax.

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A Case of Caplan's Syndrome with Silicosis: Jun Pyo Myong, Kyeong Yeon Kim, Young Lim; Korean Journal of Occupational and Environmental Medicine 2008;20(2):160-164. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.160

Abstract PDF

BACKGROUND
Caplan originally described a condition, now reffered to as Caplan's syndrome or Caplan's disease, where progressive massive fibrosis was exhibited by coal miners with multiple pulmonary nodules, and rheumatoid arthritis. This syndrome is very rare in Korea.
CASE
REPORT: The patient was a 49-year old male, with occupational history as a stonemason for 25 years. Silicosis was diagnosed by chest X-ray, while rheumatoid arthritis was diagnosed by immunological examination. Caplan's syndrome was confirmed based on these findings, occupational history, and clinical symptoms.
DISCUSSION
The authors report on the patient's Caplan's syndrome, with a particular focus on his silicosis.

Citations

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Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report
Min-Kee Yi, Won-Jun Choi, Sung-Woo Han, Seng-Ho Song, Dong-Hoon Lee, Sun Young Kyung, Sang-Hwan Han
Annals of Occupational and Environmental Medicine.2016;[Epub] CrossRef
A Case of Rheumatoid Pneumoconiosis Presenting with Pleuritis and Pericarditis
Myung Soo Park, Dae Gil Kang, Eun Ju Jung, Ki Jong Oh, Jong Seop Sim, Eun Jung Kim, Changhwan Kim
Korean Journal of Medicine.2013; 84(3): 428. CrossRef
A Case of Caplan's Syndrome Presenting as Acute Onset Polyarthritis
Han Hee Ryu, Sung Hae Chang, Hye Won Kim, Kichul Shin, Eun Bong Lee, Jae Joon Yim, Yeong Wook Song
Journal of Rheumatic Diseases.2011; 18(1): 36. CrossRef

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A Case-study of a Plastering and Waterproof Worker Suffering from Silicosis and Lung Cancer: Kyoo Sang Kim, Min Heui Jo, Byung kyu Kim; Korean Journal of Occupational and Environmental Medicine 2008;20(2):153-159. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.153

Abstract PDF

OBJECTIVES
We report on a case-study of a silicosis sufferer with lung cancer, who was exposed to cement dust through plastering and waterproof work in the construction industry.
METHODS
We reviewed his personal history including employment, medical record and estimated level of carcinogenic materials in the work place in order to evaluate the possible source of his lung cancer.
RESULTS
The patient was a non-smoker and there was no family history of lung cancer. His medical record did not reveal anything of concern. He was exposed to cement dust while he had worked for 20 years as a plasterer and waterproof worker. After complaining of chest pain, he was examined and subsequently diagnosed with lung cancer (RUL, adenocarcinoma; cT4N2M1). He was treated in a hospital for 3 months before passing away. Radiological evaluation by high resolution computed tomography (HRCT) revealed micronodules with a profusion category 1 (p/p, 1/1) in the perilymphatic distribution, which indicated silicosis. Small amounts of cement dust which included silica was identified by environmental evaluation of his work place. He never worked with asbestos related material, which was confirmed by HRCT examination.
CONCLUSIONS
We concluded that the patient's silicosis with lung cancer was an occupational-caused disease due to exposure to cement dust.

Citations

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Analysis of Cost Benefit Related to Appointing a Health Care Manager in the Construction Industry
Hye-Sun Jung, Jee-Seon Yi, In-Jae Shin, Eun-Hi Choi
Korean Journal of Occupational Health Nursing.2016; 25(2): 130. CrossRef
Assessment for the Physiological Workload of Warterproof Workers
Tae-Kyung Lim, Sang-Min Park, Dong-Eun Lee
Journal of the Architectural Institute of Korea Structure & Construction.2015; 31(6): 33. CrossRef
Occupational Cancers with Chemical Exposure and their Prevention in Korea: A Literature Review
Kyung-Taek Rim
Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3379. CrossRef
Occupational Respiratory Cancer in Korea
Hye-Eun Lee, Hyoung Ryoul Kim
Journal of Korean Medical Science.2010; 25(Suppl): S94. CrossRef

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Silica Induced Apoptosis In Vitro and In Vivo: Ji Hong Kim, Hwang Shn Chang, Yung Mann Baag, Byung Yong Ahn, Kyoung Ah Kim, Young Lim; Korean Journal of Occupational and Environmental Medicine 1999;11(2):206-212. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.206

Abstract PDF: Silica exposure results in acute inflammatory response followed by chronic fibrotic change. The mechanism for the maintenance of silica-induced inflammation has not been understood yet. Apoptosis is a morphologically distinct form of programed cell death that plays major role during homeostasis and in many diseases including cancer, acquired immune deficiency syndrome and neurodegenerative disorders. Apoptosis is characterized by cell shrinkage, membrane blebbing and nuclear condensation. To demonstrate the involvement of apoptosis in underlying mechanism for the development of silica-induced pathological changes, this study was designed in vitro and in vivo models. In in vitro study, alveolar epithelial cell line (A549) was stimulated with silica and performed flow cytometry and DNA electrophoresis. In in vivo study, bronchoalveolar lavage (BAL) was done to count the total and apoptotic cells from silica-instilled rats. The results were as follows: 1. Apoptotic cell fraction of silica-treated groups (10 and 50 microgram/cm2) was significantly higher than that of control group. 2. Genomic DNA from silica-treated groups (10 and 50 microgram/cm2 ) showed DNA ladder in agarose gel electrophoresis, while group of 1 microgram/cm2 didn't. 3. Total cell number and apoptotic cell number of BAL fluid from silica-instilled rats (10, 20 and 40 mg/kg) were significantly higher than those of control. 4. Silica induced apoptosis of cells in BAL fluid was confirmed by microscopic observation with nuclear fragmentation. These results suggest that apoptosis may contribute to development of silica-induced pathological changes.

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