title: Microscopic polyangiitis accompanied by pleuritis as the only pulmonary manifestation of occupational silica exposure.
abstract: A 68-year-old man, who had worked for processing quartz-containing stones for more than 50 years, complained of low-grade fever and arthralgia. Mediastinal lymph nodes were markedly swollen on chest computed tomography. Pathological findings of the lymph node were compatible with silicosis, with a high titer of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). During follow-up with prednisolone treatment, pleuritis and uveitis developed as manifestations of vasculitis. Thus, he was diagnosed with MPO-ANCA-associated vasculitis with occupational silica exposure, possibly microscopic polyangiitis (MPA). This case is rare, because pleuritis was the only pulmonary manifestation, without interstitial pneumonia, alveolar hemorrhage or glomerulonephritis.
authors.affiliation: Department of Respiratory Medicine, Tokyo Teishin Hospital. ccz86020@hkg.odn.ne.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Shibuya
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sano
authors.forename: Kou
authors.initials: K
authors.lastname: Osamura
authors.forename: Kosei
authors.initials: K
authors.lastname: Kujime
authors.forename: Kei
authors.initials: K
authors.lastname: Hara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hisada
mesh_terms: D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology / Q000473:pathology; D008297:Male; D055953:Microscopic Polyangiitis / Q000209:etiology*; D016273:Occupational Exposure; D009195:Peroxidase / Q000276:immunology; D010998:Pleurisy / Q000000981:diagnostic imaging / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012822:Silicon Dioxide / Q000009:adverse effects*; D012829:Silicosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D014057:Tomography, X-Ray Computed; D014605:Uveitis / Q000209:etiology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D012822:Silicon Dioxide; D011239:Prednisolone; D009195:Peroxidase