Mixed pneumoconiosis due to silicates and hard metals associated with primary Sjogren's syndrome due to silica

Ferreira, Pedro Gonçalo; Ferreira, Antonio Jorge Correia Gouveia; Carvalho, Lina; Luís, Ana R.

doi:10.1590/s1806-37132014000100016

Cited by 5 publications

(4 citation statements)

References 8 publications

(25 reference statements)

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“…In our case, with the deposition of a large amount of dust, honeycomb changes and fibroblastic foci were observed in a lower lobe, which indicated fibrogenesis and are characteristic features of UIP [11]. In contrast to ordinary UIP, fibroblastic foci are uncommon and there are a limited number of reports of these foci among cases of interstitial pneumonia complicated by pneumoconiosis [12–17]; these patients were exposed to silicates [12, 13, 16, 17], asbestos [12, 15, 16], and hard metals, such as tungsten [14, 16]. Fibroblastic foci are composed of the accumulation of fibroblasts or myofibroblasts, which play a critical role in the progression of pulmonary fibrosis, and correlate with disease progression and a poor prognosis [18].…”

Section: Discussionmentioning

confidence: 87%

Progressive plasterer’s pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report

et al. 2019

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BackgroundAlthough the prevalence of pneumoconiosis has been decreasing due to improvements in working conditions and regular health examinations, occupational hygiene measures are still being established. Plasterers encounter a number of hazardous materials that may be inhaled in the absence of sufficient protection.Case presentationA 64-year-old man who plastered without any dust protection for more than 40 years was referred to our hospital with suspected interstitial pneumonia. Mixed dust pneumoconiosis and an unusual interstitial pneumonia (UIP) pattern with fibroblastic foci were diagnosed by video-assisted thoracoscopic surgery, and an elemental analysis detected elements included in plaster work materials. Despite the cessation of plaster work and administration of nintedanib, the patient developed advanced respiratory failure.ConclusionPlasterers are at an increased risk of pneumoconiosis and may have a poor prognosis when complicated by the UIP pattern. Thorough dust protection and careful monitoring are needed.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0776-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 87%

Progressive plasterer’s pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report

et al. 2019

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“…In a prospective study by Sanchez-Roman in 1993 on 50 workers exposed to silica, systemic diseases were found in 64 % of the workers (Table 4 ), among which three cases of Sjögren’s syndrome were diagnosed as primary Sjögren’s syndrome [ 18 ]. Later, five additional cases were reported, and the disease was considered to be rare [ 5 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Later, five additional cases were reported, and the disease was considered to be rare [ 5 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report

Choi

Han

et al. 2016

Ann of Occup and Environ Med

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BackgroundThere are few reports about work-related factors associated with Sjögren’s syndrome. We report a case of overlap syndrome with Sjögren’s syndrome and systemic sclerosis.Case presentationA 54-year-old man was admitted due to dyspnea on exertion. The results of physical examination and laboratory findings were compatible with Sjögren’s syndrome with systemic sclerosis. The patient had no pre-existing autoimmune disease, and denied family history of autoimmune disease. The patient worked in the large-scale rolling department of a steel manufacturing company for 25 years. Hot rolling is a rolling process performed at between 1100 °C and 1200 °C, generating a high temperature and a large amount of fumes, involving jet-spraying of water throughout the process to remove the instantaneously generated oxide film and prevent the high generation of fumes. In this process, workers could be exposed to silica produced by thermal oxidation. Other potential toxic substances including nickel and manganese seemed to be less likely associated with the patient’s clinical manifestations.ConclusionsOccupational exposure to silica seemed to be associated with the patient’s clinical manifestations of overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Although the underlying mechanism is still unclear, autoimmune disease including Sjögren’s syndrome affects women more often than men and there was no family history of autoimmune disease. These suggested that there was an association between occupational silica exposure and the disease of the patient. Future research about the association between long-term low dose exposure to silica and the development of autoimmune diseases should be encouraged.

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“…Des Weiteren gibt es Mitteilungen über autoimmunologische Prozesse bei Vorliegen von Pneumokoniosen einschließlich Mischstaub-Pneumokoniosen [47]. U. a. sind Assoziationen der Silikose und Mischstaub-Pneumokoniosen mit einer rheumatoiden Arthritis (Caplan-Syndrom) und einem Sjögren-Syndrom [48] bekannt. Ein systematisches Review mit Metaanalyse (basierend auf 15 Fall-Kontrollstudien) ergab eine signifikante Assoziation zwischen Quarzstaub-Exposition und Sklerodermie (OR 2,81 [95% CI 1,86-4,23; p < 0,001]); auch 4 Kohortenstudien wiesen einen solchen signifikanten Zusammenhang auf [49].…”

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Diagnostische Herausforderungen bei Mischstaub-Pneumokoniosen – 5 Fallbeispiele

Baur

2020

Pneumologie

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ZusammenfassungDie Exposition gegenüber granulären und faserförmigen anorganischen alveolengängigen Stäuben führt zu inflammatorischen und fibrosierenden Lungenveränderungen. Außerdem geht sie mit einem erhöhten Lungenkrebsrisiko einher. Unter Berücksichtigung einer eingehenden Arbeitsanamnese bereitet die Diagnose der relativ häufigen Pneumokoniosen Silikose und Asbestose bei vorherrschender Ausprägung mit vorwiegend rundlichen bzw. irregulären Verschattungen und Betonung der Ober- bzw. Unterfelder kaum Schwierigkeiten. Jedoch liegt im einzelnen Erkrankungsfall selten eine Monoexposition vor. Vielmehr finden sich praktisch immer gleichzeitig Mischexpositionen, z. B. im Steinkohlenbergbau Quarz und Kohlenstoff, im Baugewerbe Quarz, Asbest, verschiedene weitere Zement- und Betonbestandteile, z. T. auch Hartmetalle und Schweißrauche. Des Weiteren kommt es im Laufe eines Arbeitslebens durch Veränderungen der Produktionsprozesse und der Ausgangsmaterialien und infolge Arbeitsplatz-/Berufswechsel zu Variationen der Art und Intensität solcher Belastungen. Die damit einhergehende Heterogenität der Exposition und der damit verbundenen intrapulmonalen Deposition hat Einfluss auf die resultierenden strukturellen Lungenveränderungen, d. h. es kommt zu mehr oder weniger ausgeprägten Abweichungen der morphologischen Strukturen von in den Lehrbüchern als typisch dargestellten Pneumokoniosebildern. Dadurch kann sich die Diagnostik schwierig gestalten, insbesondere die Abgrenzung zu idiopathischen interstitiellen Lungenerkrankungen gelingt oft nicht mehr sicher. Zu berücksichtigen sind außerdem genetische Einflüsse hinsichtlich der Krankheitssuszeptibilität und des Ausmaßes der pathohistologisch und radiologisch feststellbaren Veränderungen.Es werden 5 Fallbeispiele dargestellt, die durchwegs initial als idiopathische Lungenfibrose gedeutet wurden, deren genaue Aufarbeitung – großteils im Rahmen der Sozialgerichtsbarkeit − durch den Autor jedoch stets eine Mischstaub-Pneumokoniose wahrscheinlich machte.

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Mixed pneumoconiosis due to silicates and hard metals associated with primary Sjogren's syndrome due to silica

Cited by 5 publications

References 8 publications

Progressive plasterer’s pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report

Progressive plasterer’s pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report

Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report

Diagnostische Herausforderungen bei Mischstaub-Pneumokoniosen – 5 Fallbeispiele

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