Sarcoidosis in a patient clinically diagnosed with silicosis; is silica associated sarcoidosis a new phenotype?. (2019)

• Record Type: Journal Article
• Authors: Beijer, Els; Meek, Bob; Kromhout, Hans; van Es, H. Wouter; Seldenrijk, Kees; Drent, Marjolein; Rooijackers, Jos M.; Veltkamp, Marcel
• Is Part Of: Respiratory medicine case reports. Volume 28(2019)
• Publication Date: 2019
• Subjects: Silicosis -- Sarcoidosis -- Sarcoidosis phenotypes -- Silica -- Infliximab; 18 F-FDG PET/CT 18F-fluorodeoxyglucose by positron emission tomography/computed tomography -- CBD Chronic beryllium disease -- DLCO diffusing capacity of the lung for carbon monoxide -- EDXA Energy-dispersive X-ray spectroscopy analysis -- FVC Forced Vital Capacity -- HRCT High-resolution computed tomography -- LPT Lymphocyte proliferation test; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2019.100906
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: A diagnosis of silicosis is made on the basis of exposure and typical radiological findings, according to the ILO's International Classification of Radiographs of Pneumoconiosis. Radiological patterns of silicosis can, however, resemble sarcoidosis. Sarcoidosis is a multi-systemic disorder of unknown etiology, although a role for initiating inorganic triggers such as metals or silica has been suggested. In this case report, we illustrate a patient previously diagnosed with silicosis based on exposure and radiological features, progressive under immunosuppressive treatment. In view of these findings, an open lung biopsy was performed and revealed sarcoidosis. The patient was effectively treated with infliximab. Further analysis showed the presence of silica in the granulomas. Sensitization to silica was also demonstrated, suggesting an association between silica exposure and sarcoidosis in this patient.