A Case of Goodpasture's Syndrome in a Foundry Worker

Kim, Min Gi; Koh, Dong Hee; Lee, Sun Wong; Jo, Min Heui; Yoo, Hee Yong; Kim, Bo Yeon; Lee, June Hyuk

doi:10.35371/kjoem.2008.20.1.46

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…This disease is characterized by pulmonary hemorrhage and glomerulonephritis and is mediated by autoantibodies directed against the basement membrane in the renal glomerulus and the pulmonary alveolus. The etiology of Goodpasture's Syndrome is still unknown; however, development of the disease following crystalline silica exposure has been reported in at least three case reports [ 3 – 5 ]. Other exposures have also been implicated as causal factors, including hydrocarbons [ 6 , 7 ], cocaine use [ 8 ], hard metal dust [ 9 ], and D -penicillamine [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…A workplace survey found that the exposure level of respirable crystalline silica exceeded the exposure limit, a TLV-TWA of 0.0106 mg/m 3 which was calibrated for overtime. The authors conclude that based on his clinical presentation and industrial hygiene examination, his Goodpasture's syndrome was caused by long-term silica exposure [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Goodpasture's Syndrome and Silica: A Case Report and Literature Review

Dahlgren¹,

Wardenburg²,

Peckham³

2010

Case Reports in Medicine

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We report a case of Goodpasture's syndrome following chronic low level and an acute, high level of exposure to crystalline silica. A 38-year-old male tilesetter was admitted to the emergency room with dyspnea and respiratory failure. He reported that his symptoms had developed over the previous week after inhaling a large amount of dust while dry-sanding and sweeping a silica-based product used to fill cracks in a cement floor. Over the following days, his pulmonary function declined and he developed acute renal failure. Tests of antiglomerular basement membrane antibody were positive and renal biopsy revealed global glomerulonephritis. He was diagnosed with Goodpasture's syndrome and treated with steroids, plasmapheresis, and hemodialysis. This man had a history of childhood asthma and a remote, one pack-year history of cigarette use. He used the flooring product for seven years prior to the inciting event, however, previous jobs had utilized significantly smaller amounts. Goodpasture's syndrome and other autoimmune diseases have been reported in association with silica exposure. The acute onset following high level silica exposure in this previously healthy man, suggest that clinicians should investigate silica exposure as a causal factor in cases of Goodpasture's syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Goodpasture's Syndrome and Silica: A Case Report and Literature Review

Dahlgren¹,

Wardenburg²,

Peckham³

2010

Case Reports in Medicine

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“…Some epidemiologic evidence suggests that occupational exposures to crystalline silica may also be associated with renal and autoimmune diseases such as systemic sclerosis and rheumatoid arthritis [10] . In addition, Goodpasture's syndrome, the autoimmune disease of glomerulus, in foundry workers has been linked to a long-term exposure to crystalline silica [11] . Preventable deaths due to fatal injuries as well as suicide [1] , [3] have also been implicated as a significant cause of death among foundry workers.…”

Section: Introductionmentioning

confidence: 99%

Cause-Specific Mortality Due to Malignant and Non-Malignant Disease in Korean Foundry Workers

Yoon

Ahn

2014

PLoS ONE

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BackgroundFoundry work is associated with serious occupational hazards. Although several studies have investigated the health risks associated with foundry work, the results of these studies have been inconsistent with the exception of an increased lung cancer risk. The current study evaluated the mortality of Korean foundry workers due to malignant and non-malignant diseases.MethodsThis study is part of an ongoing investigation of Korean foundry workers. To date, we have observed more than 150,000 person-years in male foundry production workers. In the current study, we stratified mortality ratios by the following job categories: melting-pouring, molding-coremaking, fettling, and uncategorized production work. We calculated standard mortality ratios (SMR) of foundry workers compare to general Korean men and relative risk (RR) of mortality of foundry production workers reference to non-production worker, respectively.ResultsKorean foundry production workers had a significantly higher risk of mortality due to malignant disease, including stomach (RR: 3.96; 95% CI: 1.41–11.06) and lung cancer (RR: 2.08; 95% CI: 1.01–4.30), compared with non-production workers. High mortality ratios were also observed for non-malignant diseases, including diseases of the circulatory (RR: 1.92; 95% CI: 1.18–3.14), respiratory (RR: 1.71; 95% CI: 1.52–21.42 for uncategorized production worker), and digestive (RR: 2.27; 95% CI: 1.22–4.24) systems, as well as for injuries (RR: 2.36; 95% CI: 1.52–3.66) including suicide (RR: 3.64; 95% CI: 1.32–10.01).ConclusionThis study suggests that foundry production work significantly increases the risk of mortality due to some kinds of malignant and non-malignant diseases compared with non-production work.

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Goodpasture’s Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association

Bal

Das

Gupta

et al. 2014

Case Reports in Pulmonology

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Introduction. Goodpasture's syndrome is a rare clinical entity and is characterized by circulating autoantibodies which are principally directed against the glomerular/alveolar basement membrane. The etiology of Goodpasture's syndrome is still unknown. Lung involvement occurs as a result of lung injury and the exposure of new epitopes to the immune system. Recently, several studies have suggested the role of silica as one of etiological factors in ANCA associated vasculitis and glomerulonephritis. Materials and Methods. We present a case of a 40-year-old welder with silicosiderosis, who developed anti-GBM disease with p-ANCA positivity. Case Report. Patient presented to an emergency with gradually increasing breathlessness along with renal failure and died after short hospital stay. Autopsy pathology findings revealed crescentic glomerulonephritis with linear glomerular basement membrane antibody deposition, splenic vasculitis, pulmonary haemorrhage, and pulmonary silicosiderosis. Conclusion. This case reinforces the role of environmental triggers like exposure to silica, metal dust, and tobacco in pathogenesis of Goodpasture's syndrome and p-ANCA associated vasculitis.

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A Case of Goodpasture's Syndrome in a Foundry Worker

Cited by 3 publications

References 23 publications

Goodpasture's Syndrome and Silica: A Case Report and Literature Review

Goodpasture's Syndrome and Silica: A Case Report and Literature Review

Cause-Specific Mortality Due to Malignant and Non-Malignant Disease in Korean Foundry Workers

Goodpasture’s Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association

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