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BMJ Case Rep ; 12(12)2019 Dec 11.
Article in English | MEDLINE | ID: mdl-31831514

ABSTRACT

Chronic silicosis is an entity widely described in literature. However, other types such as accelerated, acute, complicated and extrapulmonary silicosis are little documented. We present a case of accelerated extrapulmonary silicosis in a lung transplant patient in whom the diagnosis of systemic silicosis was made incidental to non-respiratory complications that occurred during follow-up. The appearance of cytopenia and liver failure led to diagnostic tests that documented the presence of silicotic granulomas in those locations. Taking into account the intensity, time of exposure, onset and development of the disease, we found a highly atypical case of accelerated extrapulmonary silicosis in which inorganic particles (presumably silica) were documented inside granulomas and macrophages of the bone marrow. With these findings, we reflect on the lack of consideration of these entities within clinical practice, their probable under diagnosis and the need to study other pathophysiological mechanisms of acquisition and dissemination of silicosis.


Subject(s)
Granuloma, Foreign-Body/diagnosis , Occupational Diseases/physiopathology , Silicosis/physiopathology , Adult , Bone Marrow/pathology , Granuloma, Foreign-Body/pathology , Humans , Liver/pathology , Lung Transplantation , Male , Occupational Diseases/complications , Occupational Diseases/diagnostic imaging , Pneumonectomy , Silicon Dioxide/adverse effects , Silicosis/complications , Silicosis/diagnostic imaging , Splenomegaly/etiology
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