Microscopic polyangiitis accompanied by pleuritis as the only pulmonary manifestation of occupational silica exposure.
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.
Shibuya
Hideki
H
Department of Respiratory Medicine, Tokyo Teishin Hospital. ccz86020@hkg.odn.ne.jp
Sano
Hiroko
H
Osamura
Kou
K
Kujime
Kosei
K
Hara
Kei
K
Hisada
Tetsuya
T
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
D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D012822:Silicon Dioxide; D011239:Prednisolone; D009195:Peroxidase