Silica-Associated Systemic Lupus Erythematosus in an Elderly Man

Abstract

The predominantly young woman-orientated systemic lupus erythematosus (SLE) is a disease that involves an extremely complicated and multifactorial interaction of various genetic and environmental factors. Crystalline silica (Si) may act as an immunoadjuvant to increase secretions of inflammatory endogenous substances and antibody production. In addition, previous studies have suggested that exposure to Si may induce SLE. Although the biologic mechanism of Si in SLE is unclear, defective apoptosis leading to the prolonged survival of pathogenic lymphocytes was thought to be one of mechanisms of Si-associated SLE (sSLE). In the present study, a rare case of an elderly man suffering from sSLE responded well to glucocorticoid therapy. The present findings were reviewed with reference to previous literature.

Silica exposure and altered regulation of autoimmunity

“…The typical autoimmune disorders complicated with silicosis include rheumatoid arthritis (well known as Caplan syndrome) [5,6], systemic lupus erythematosus (SLE) [7,8], systemic sclerosis (SSc) [9,10], and anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis [11][12][13][14].…”

Environmental factors producing autoimmune dysregulation – Chronic activation of T cells caused by silica exposure

“…Complicated rheumatoid arthritis is known as Caplan's syndrome (Caplan 1959;Caplan et al 1962). Moreover, SLE (Bartsch et al 1980;Yamazaki et al 2007), systemic sclerosis (SSc) (Sluis-Cremer et al 1985;Haustein et al 1990), and anti-neutrophil cytoplasmic autoantibody (ANCA)-related vasculitis/nephritis (Saeki et al 2004;Bartůnková et al 2006) have been reported as complications of silicosis.…”

Selected work-related nephropathies

“…Inne choroby immunologiczne i nefropatie indukowane krzemionką Jak wspomniano wyżej, w wyniku niektórych badań wykazywano związek narażenia na krzemionkę z innymi chorobami immunologicznymi, takimi jak SLE [55], RZS, czy twardziną układową [42]. Poza KZN w przebiegu AAV opisano indukowany krzemionką przypadek zespołu Goodpasteura [42], a także przypadki nefropatii IgA (nephropathy IgA -NIgA) u osób narażonych na krzemionkę [56].…”