Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report

Abstract

BackgroundThere are few reports about work-related factors associated with Sjögren’s syndrome. We report a case of overlap syndrome with Sjögren’s syndrome and systemic sclerosis.Case presentationA 54-year-old man was admitted due to dyspnea on exertion. The results of physical examination and laboratory findings were compatible with Sjögren’s syndrome with systemic sclerosis. The patient had no pre-existing autoimmune disease, and denied family history of autoimmune disease. The patient worked in the large-scale rolling department of a steel manufacturing company for 25 years. Hot rolling is a rolling process performed at between 1100 °C and 1200 °C, generating a high temperature and a large amount of fumes, involving jet-spraying of water throughout the process to remove the instantaneously generated oxide film and prevent the high generation of fumes. In this process, workers could be exposed to silica produced by thermal oxidation. Other potential toxic substances including nickel and manganese seemed to be less likely associated with the patient’s clinical manifestations.ConclusionsOccupational exposure to silica seemed to be associated with the patient’s clinical manifestations of overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Although the underlying mechanism is still unclear, autoimmune disease including Sjögren’s syndrome affects women more often than men and there was no family history of autoimmune disease. These suggested that there was an association between occupational silica exposure and the disease of the patient. Future research about the association between long-term low dose exposure to silica and the development of autoimmune diseases should be encouraged.

Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports

“…Occupations that have previously been connected to crystalline silica-related systemic sclerosis include gold, coal, or iron miners, stone quarry cutters, mining shotfirers, ceramics workers, millers, stonemasons, and stone crushers [ 11 – 21 ]. However, there has never been a reported case of crystalline silica-related systemic sclerosis in crystal processing workers in the jewelry-processing field.…”