GM‐CSF antibodies in artificial stone associated silicoproteinosis: A case report and literature review

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare lung disease where there is accumulation of surfactant in the alveoli. It can be classified based on the underlying aetiology into three categories: primary, secondary and congenital. Autoantibodies to granulocyte‐macrophage colony‐stimulating factor (GM‐CSF‐Ab) are a key diagnostic feature of autoimmune PAP. High intensity occupational exposure and inhalation of toxic particles such as silica can cause a form of secondary PAP called acute silicoproteinosis. We describe a 26‐year‐old stone benchtop fabricator with silicoproteinosis following daily exposure to high levels of silica who had elevated serum GM‐CSF‐Ab. We discuss the role of GM‐CSF‐Ab in cases of PAP with occupational inhalational exposure and the challenges in its interpretation.

Workers with Suspected Diagnosis of Silicosis: A Case Study of Sarcoidosis Versus Siderosis

“…Silicosis develops slowly over a long period of exposure to crystalline silica. In more advanced stages of the disease, a persistent cough, shortness of breath, and fatigue usually occur, and these symptoms may become more evident [ 5 , 6 ].…”

“…(B) Acute silicosis is a rapidly progressive clinical condition after intense exposure to free silica [ 5 ]. (C) Acute silicoproteinosis, which is a rare variant manifested as a bilateral perihilar alveolar infiltrate with a ‘ground-glass’ appearance [ 6 ]. Additionally, (D), there is accelerated silicosis, which is another under-defined clinical form that occurs after exposure to higher amounts of silica over a shorter period (5–15 years) [ 7 ].…”