Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

Mochizuka, Yasutaka; Kono, Masato; Katsumata, Michio; Hirama, Ryutaro; Watanuki, Masayuki; Oshima, Yuiko; Takeda, Kôsaku; Tsutsumi, Akari; Miwa, Hideki; Miki, Yuko; Dai, Huaping; Enomoto, Noriyuki; Suda, Takafumi; Nakamura, Hidenori

doi:10.2169/internalmedicine.7533-21

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…These criteria are: clinical presentation compatible with sarcoidosis, the presence of non-necrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease [19]. Various causative agents have been linked to sarcoidosis, including silica-containing cat litter [7,14]. Many features were consistent with sarcoidosis in the current case, mainly the calcitriol meditated hypercalcemia and the good response to steroid therapy.…”

Section: Discussionmentioning

confidence: 61%

“…Exposure to silica dust is one of the oldest known causes of pulmonary diseases, and is associated with a variety of occupations, such as construction, quarrying, and chemical industries [1]. While the inhalation of fine silica particles is a well-recognized risk factor for silicosis, several studies have reported an association between silica exposure and sarcoidosis or sarcoid-like granulomatous lung diseases [2][3][4][5][6][7][8]. According to the literature, silica exposure may also be a trigger for other conditions, including hypersensitivity pneumonitis (HP), lung cancer, tuberculosis, chronic obstructive pulmonary disease, and kidney disease [7,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Hubska

Shahnazaryan

Rosłon

et al. 2022

IJERPH

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A 44-year-old woman was admitted to hospital with end-stage renal failure, productive cough, and decreased exercise tolerance. She had owned nine cats, which resulted in long-term exposure (18 years) to silica-containing bentonite cat litter. High-resolution computed tomography of the chest showed micronodular lesions in the lungs, and mild mediastinal lymphadenopathy. A lung biopsy revealed multinucleated giant cells, some of which had birefringent material and Schaumann bodies. X-ray photoelectron spectroscopy revealed the presence of silicon in the lung biopsy specimen, as well as in the patient’s cat litter. The pulmonary condition was suggestive of sarcoid-like lung disease, rather than silicosis, sarcoidosis, or hypersensitivity pneumonitis, according to the clinicopathological findings. Renal failure appeared to be a result of chronic hypercalcemia due to extrarenal calcitriol overproduction in activated alveolar macrophages. Ultimately, the patient was diagnosed with sarcoid-like lung disease complicated by end-stage renal failure from exposure to bentonite cat litter. Therapy with steroids, in addition to elimination of the bentonite cat litter exposure, resulted in a significant improvement in the health condition. At a follow-up visit after 4 months, an almost complete resolution of the lung lesions and a significant improvement in renal function were observed.

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Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Hubska

Shahnazaryan

Rosłon

et al. 2022

IJERPH

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“…The surgical biopsy demonstrated that multiple sarcoid-like granulomas were composed of clustered epithelioid and multinucleated giant cells, while the silica nodules were mainly composed of dust-laden hyalinized collagen, and pathologic findings of aluminous showed diffuse interstitial fibrosis with emphysema. Recent case reports have postulated that sarcoid-like granulomatous lung disease can also be induced by silicates ( 21 , 22 ). Different epidemiological studies have demonstrated a higher risk of sarcoidosis among persons occupationally exposed to silica ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary sarcoid-like granulomatosis induced by aluminum dust: A case report and literature review

Song²,

Feng³

et al. 2023

Front. Med.

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Case reportWe present a case of a 48-year-old woman with 27 months of exposure to aluminum dust and silica owing to polishing processing. The patient was admitted to our hospital with intermittent cough and expectoration. Chest high-resolution computed tomography showed diffuse ill-defined centrilobular nodules and patchy ground-glass opacities in bilateral lungs. A video-assisted thoracoscopic surgery biopsy demonstrated multiple isolated and confluent granulomas in an otherwise normal parenchyma without malignancy or signs of infection. Elemental analysis was performed on the grinding wheel powder in the workplace using an X-ray fluorescence spectrometric analyzer, showing 72.7% of Al2O3 and 22.8% of SiO2 as raw materials. She was diagnosed with aluminum-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to occupational exposure by a multidisciplinary panel.ConclusionOccupational aluminum dust exposure may induce pulmonary sarcoid-like granulomatosis recognized by a multidisciplinary diagnostic panel.

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“…Sarcoidosis is a multisystem granulomatous disease of unknown aetiology whose immunological mechanism has not yet been identified [ 24 ]. This fact has led some authors to establish the diagnosis of sarcoidosis from the exclusion of other sarcoid-like diseases, according to its clinicopathological findings [ 25 ]. Siderosis is a benign pneumoconiosis that develops as a result of exposure to metallic iron or iron oxide dust [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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

Delgado-García,

Miranda-Astorga,

Delgado-Cano

et al. 2023

Healthcare

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Silicosis is one of the most important occupational respiratory diseases worldwide, hence the importance of making a correct diagnosis. Diagnosis is commonly based on radiological findings according to the ILO International Classification of Radiographs of Pneumoconioses and occupational exposure. High-resolution computed tomography is indicated for differential diagnosis. This article presents two cases with an initial diagnosis of silicosis that ended up being diagnosed as sarcoidosis and siderosis, respectively. The first case was a 42-year-old male who worked as a crushing operator in an underground copper and molybdenum mine for 22 years. He had a history of exposure to silicon dioxide and was asymptomatic. X-rays did not distinguish silicosis or siderosis, but histological findings (open lung biopsy) allowed for a diagnosis of sarcoidosis. The second case was a 50-year-old male who had worked as a welder in a molybdenum filter plant, an open pit mine since 2013; he spent the previous 20 years as a welder in an underground copper mine, with exposure to silicon dioxide and was symptomatic. The first radiograph showed opacities that were compatible with pulmonary silicosis. A subsequent high-resolution computed tomography and lung biopsy showed a pattern of pulmonary siderosis. Due to the similarities in the radiographs of these three diseases, greater emphasis must be placed on the differential diagnosis, for which a complete occupational and clinical history is important in order to provide clues for the performance of complementary tests to avoid misdiagnosing.

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Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

Cited by 3 publications

References 18 publications

Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Pulmonary sarcoid-like granulomatosis induced by aluminum dust: A case report and literature review

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

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