Granulomatous lung disease in two workers making light bulbs

Ronsmans, Steven; Verbeken, Eric; Adams, Els; Keirsbilck, Stephan; Yserbyt, Jonas; Wuyts, Wim; Swennen, R.; Hoet, Peter; Nemery, Benoît

doi:10.1002/ajim.23030

Cited by 11 publications

(14 citation statements)

References 25 publications

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“…Among the inorganic dust particles most consistently associated with increased risk for sarcoidosis are respirable crystalline silica (RCS) and silicates. 10,[15][16][17][18][19][20][21][22] Case Reports: Kawano-Dourado et al 15 27 In the 12-month period following exposure, the incidence rate was 86 per 100,000; and in 2015, the average annual incidence rate was 25 per 100,000. 27,28 During the period 1985 to 1998, Prezant et al 29 observed an average annual incidence rate among NYC firefighters of 12.9 per 100,000, with a range of 0 to 43.6 per 100,000.…”

Section: Silica and Silicatesmentioning

confidence: 99%

Sarcoidosis

Oliver

Zarnke

2021

Chest

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Sarcoidosis is an important member of the family of granulomatous lung diseases. Since its recognition in the late 19th century, sarcoidosis has been thought of as a disease of unknown cause. Over the past 20 years, this paradigm has been shifting, more rapidly in the past 10 years. Epidemiologic studies, bolstered by case reports, have provided evidence of causal associations between occupational exposure to specific agents and sarcoidosis. Pathogenesis has been more clearly defined, including the role of gene-exposure interactions. The use of in vitro lymphocyte proliferation testing to detect sensitization to inorganic antigens is being examined in patients with sarcoidosis. These antigens include silica and certain metals. Results of studies to date show differences in immunoreactivity of occupationally exposed sarcoidosis cases compared with control cases, suggesting that lymphocyte proliferation testing may prove useful in diagnosing work-related disease. This review discusses recently published findings regarding associations between occupational exposure to silica and silicates, World Trade Center dust, and metals and risk for sarcoidosis, as well as advances in the development of diagnostic tools. Not all cases of sarcoidosis have an identified cause, but some do. Where the cause is occupational, its recognition is critical to enable effective treatment through removal of the affected worker from exposure and to inform intervention aimed at primary prevention.

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Section: Silica and Silicatesmentioning

confidence: 99%

Sarcoidosis

Oliver

Zarnke

2021

Chest

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“…As this association has hardly been investigated, confirmation in other populations is warranted, preferably including more patients with rare organ manifestations. Future longitudinal studies could clarify whether not only disease presentation but also prognosis is related to exposure and if stopping or reducing these exposures could alter the disease course [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis

et al. 2021

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Background Sarcoidosis most commonly affects lungs and intrathoracic lymph nodes, but any other organ can be involved. In epidemiological studies, many occupational and environmental exposures have been linked to sarcoidosis but their relationship with the disease phenotype has barely been studied. Objective To investigate how occupational and environmental exposures prior to diagnosis relate to organ involvement in patients with sarcoidosis Methods We retrospectively studied patients seen at a sarcoidosis clinic between 2017 and 2020. Patients were included if they had a clinical presentation consistent with sarcoidosis and histologically confirmed epithelioid granulomas or had Löfgren syndrome. In a case–case analysis using multivariable logistic regression we calculated odds ratios (OR) of prespecified exposure categories (based on expert ascertainment) for cases with a given organ involvement versus cases without this organ involvement. Results We included 238 sarcoidosis patients. Sarcoidosis limited to pulmonary involvement was associated with exposure to inorganic dust prior to diagnosis (OR 2.11; 95% confidence interval [CI] 1.11–4.17). Patients with liver involvement had higher odds of contact with livestock (OR 3.68; 95% CI 0.91–12.7) or having jobs with close human contact (OR 4.33; 95% CI 1.57–11.3) than patients without liver involvement. Similar associations were found for splenic involvement (livestock: OR 4.94, 95% CI 1.46–16.1; close human contact: OR 3.78; 95% CI 1.47–9.46). Cardiac sarcoidosis was associated with exposure to reactive chemicals (OR 5.08; 95% CI 1.28–19.2) or livestock (OR 9.86; 95% CI 1.95–49.0). Active smokers had more ocular sarcoidosis (OR 3.26; 95% CI 1.33–7.79). Conclusions Our study indicates that, in sarcoidosis patients, different exposures might be related to different organ involvements—hereby providing support for the hypothesis that sarcoidosis has more than one cause, each of which may promote a different disease phenotype.

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“…Silica exposure has been associated with sarcoidosis or sarcoid-like granulomatous lung disease (8)(9)(10)(11)(12)(13). Epidemiological studies have noted a high incidence of sarcoidosis in patients with silica exposure (10,11).…”

Section: A B C D Ementioning

confidence: 99%

“…Inhalation of beryllium can cause granulomatous lung disease that mimics sarcoidosis (7), and other metals and inorganic dust have also been associated with a granulomatous response (4)(5)(6). Silica might be a trigger for sarcoidlike granulomatous lung disease, and several studies have reported the association between silica exposure and sarcoidosis or sarcoid-like granulomatous lung diseases (8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

et al. 2022

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A 67-year-old man was admitted to our hospital with cough and fatigue. He had had long-term exposure to silica due to cement processing. Chest computed tomography showed bilateral centrilobular nodules, and hilar and mediastinal lymphadenopathy with calcification, suggesting chronic silicosis. Within a few months, these nodules enlarged, and bilateral patchy consolidations appeared. A lung biopsy revealed sarcoid-like granulomas with birefringent particles under polarized light without malignancy or infection. He was diagnosed with silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to the clinicopathological findings. His pulmonary manifestations improved after the discontinuation of silica exposure and combination therapy of corticosteroid and azathioprine.

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Granulomatous lung disease in two workers making light bulbs

Cited by 11 publications

References 25 publications

Sarcoidosis

Sarcoidosis

Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis

Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

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