Steven Ronsmans1,2, Eric K Verbeken3, Els Adams1,4, Stephan Keirsbilck1,4, Jonas Yserbyt5, Wim A Wuyts5, Rudy Swennen6, Peter Hm Hoet2, Benoit Nemery1,2. 1. Department of Pulmonary Medicine, Clinic of Occupational and Environmental Medicine, University Hospitals Leuven, Leuven, Belgium. 2. Department of Public Health and Primary Care, Centre for Environment and Health, University of Leuven, Leuven, Belgium. 3. Department of Pathology, University Hospitals Leuven, Leuven, Belgium. 4. IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium. 5. Department of Pulmonary Medicine, Unit for Interstitial Lung Diseases, University Hospitals Leuven, Leuven, Belgium. 6. Department of Earth and Environmental Science, Geology, University of Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Associations between sarcoidosis or sarcoid-like granulomatous lung disease and exposure to silica and other inorganic agents have been suggested in several studies. CASES: We describe granulomatous lung disease in two workers of a small production unit making metal-halide lamps. Initially, both were diagnosed with sarcoidosis. However, in both men, birefringent particles were observed in the lung or mediastinal lymph node biopsies. Clipping of glass tubes led to moderate exposure to dust, consisting mainly of amorphous fused silica, with some cristobalite. After removal from exposure, both subjects improved clinically, radiologically, and functionally. CONCLUSION: The present cases support the hypothesis that silica might be a trigger for sarcoid-like granulomatous lung disease. Sarcoidosis should be considered a diagnosis of exclusion and clinicians should carefully collect occupational and environmental exposure histories to identify workplace triggers.
BACKGROUND: Associations between sarcoidosis or sarcoid-like granulomatous lung disease and exposure to silica and other inorganic agents have been suggested in several studies. CASES: We describe granulomatous lung disease in two workers of a small production unit making metal-halide lamps. Initially, both were diagnosed with sarcoidosis. However, in both men, birefringent particles were observed in the lung or mediastinal lymph node biopsies. Clipping of glass tubes led to moderate exposure to dust, consisting mainly of amorphous fused silica, with some cristobalite. After removal from exposure, both subjects improved clinically, radiologically, and functionally. CONCLUSION: The present cases support the hypothesis that silica might be a trigger for sarcoid-like granulomatous lung disease. Sarcoidosis should be considered a diagnosis of exclusion and clinicians should carefully collect occupational and environmental exposure histories to identify workplace triggers.
Authors: Joanna Hubska; Urszula Shahnazaryan; Marek Rosłon; Benedykt Szczepankiewicz; Kostiantyn Nikiforow; Marcin Pisarek; Małgorzata Barnaś; Urszula Ambroziak Journal: Int J Environ Res Public Health Date: 2022-10-09 Impact factor: 4.614
Authors: Steven Ronsmans; Jolien De Ridder; Eline Vandebroek; Stephan Keirsbilck; Benoit Nemery; Peter H M Hoet; Steven Vanderschueren; Wim A Wuyts; Jonas Yserbyt Journal: Respir Res Date: 2021-08-09