Treatment of Acute Silicoproteinosis by Whole-Lung Lavage

Stafford, Marshall; Cappa, Anthony; Weyant, Michael J.; Lara, Abigail; Ellis, James V.; Weitzel, Nathaen; Puskás, Ferenc

doi:10.1177/1089253213486524

Cited by 24 publications

(21 citation statements)

References 25 publications

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“…In PAP, whole lung lavage (WLL) clears the accumulated material from the airspaces, and a significant body of nonrandomized evidence strongly supports the safety and efficacy of this therapeutic approach 92. Similarities between PAP and silicoproteinosis suggest that WLL may have therapeutic potential in the nonfibrotic forms of silicosis, a contention supported by case reports and series 93,94…”

Section: Emerging Treatment Optionsmentioning

confidence: 80%

Silica‐related diseases in the modern world

Hoy

Chambers

2020

Allergy

247

174

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Silicosis is an ancient and potentially fatal pneumoconiosis caused by exposure to respirable crystalline silica. Silicosis is historically a disease of miners; however, failure to recognize and control the risk associated with silica exposure in contemporary work practices such as sandblasting denim jeans and manufacturing of artificial stone benchtops has led to re‐emergence of silicosis around the world. This review outlines the mineralogy, epidemiology, clinical and radiological features of the various forms of silicosis and other silica‐associated diseases. Perspective is provided on the most recent studies shedding light on pathogenesis, including the central role of innate immune effector cells and subsequent inflammatory cascades in propagating pulmonary fibrosis and the extrapulmonary manifestations, which uniquely characterize this pneumoconiosis. Clinical conundrums in differential diagnosis, particularly between silicosis and sarcoidosis, are highlighted, as is the importance of obtaining a careful occupational history in the patient presenting with pulmonary infiltrates and/or fibrosis. While silicosis is a completely preventable disease, unfortunately workers around the world continue to be affected and experience progressive or even fatal disease. Although no treatments have been proven, opportunities to intervene to prevent progressive disease, founded in a thorough cellular and molecular understanding of the immunopathology of silicosis, are highlighted.

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Section: Emerging Treatment Optionsmentioning

confidence: 80%

Silica‐related diseases in the modern world

Hoy

Chambers

2020

Allergy

247

174

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“…In silicosis patients WLL may remove large quantities of dust, soluble materials, and inflammatory cells from the lungs and relieve respiratory symptoms, but sustained improvement in lung function parameters has not been shown in a clinical trial 1 ) . Several studies have reported WLL performed also in acute silicoproteinosis 19 , 20 ) . Karnak et al.…”

Section: Discussionmentioning

confidence: 99%

Case of accelerated silicosis in a sandblaster

et al. 2015

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Sandblasting is traditionally known as a high-risk profession for potential development of lung silicosis. Reported is a case of a sandblaster with confirmed accelerated silicosis, a condition rather rarely diagnosed in the Czech Republic. Initially, the patient presented with progressive dry cough and exertional dyspnoea. In the early diagnostic process, a possible occupational aetiology was considered given his occupational history and known high-risk exposure to respirable silica particles confirmed by industrial hygiene assessment at the patient’s workplace. The condition was confirmed by clinical, histological and autopsy findings. The patient died during lung transplantation, less than five years from diagnosis.

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“…Although it decreases the presence of dust particles, macrophages and cytokines on subsequent BAL analysis, and may decrease lung function decline in the short term, it does not appear to have an impact on long‐term outcomes or mortality . Furthermore, potential treatment‐related complications including respiratory failure are of serious concern …”

Section: Treatmentmentioning

confidence: 99%

Silica‐associated lung disease: An old‐world exposure in modern industries

et al. 2019

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Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have recently experienced significant outbreaks of silicosis. These outbreaks have occurred in modern industries such as denim jean production, domestic benchtop fabrication and jewellery polishing, where silica has been introduced without recognition and control of the hazard. Much of our understanding of silica‐related lung disease is derived from traditional occupations such as mining, whereby workers may develop slowly progressive chronic silicosis. However, workers in modern industries are developing acute and accelerated silicosis over a short period of time, due to high‐intensity silica concentrations, oxidative stress from freshly fractured silica and a rapid pro‐inflammatory and pro‐fibrotic response. Appropriate methods of screening and diagnosis remain unclear in these workers, and a significant proportion may go on to develop respiratory failure and death. There are no current effective treatments for silicosis. For those with near fatal respiratory failure, lung transplantation remains the only option. Strategies to reduce high‐intensity silica dust exposure, enforced screening programmes and the identification of new treatments are urgently required.

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Treatment of Acute Silicoproteinosis by Whole-Lung Lavage

Cited by 24 publications

References 25 publications

Silica‐related diseases in the modern world

Silica‐related diseases in the modern world

Case of accelerated silicosis in a sandblaster

Silica‐associated lung disease: An old‐world exposure in modern industries

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