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Case report
Accelerated silicosis with bone marrow, hepatic and splenic involvement in a patient with lung transplantation
  1. M Cruz Carreño Hernández1,
  2. Sara Garrido Paniagua2,
  3. María Colomés Iess3 and
  4. Mehdi Guemra4
  1. 1Internal Medicine Department, Hospital Universitario Puerta del Hierro Majadahonda, Majadahonda, Madrid, Spain
  2. 2Hematology and Hemotherapy Department, Hospital Universitario Puerta del Hierro Majadahonda, Majadahonda, Madrid, Spain
  3. 3Pathology Department, Hospital Universitario Puerta del Hierro Majadahonda, Majadahonda, Madrid, Spain
  4. 4Clinical Biochemistry Department, Hospital Universitario Puerta del Hierro Majadahonda, Majadahonda, Madrid, Spain
  1. Correspondence to Dr Mehdi Guemra; mguemrao{at}gmail.com

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.

  • exposures
  • pathology
  • migration and health
  • interstitial lung disease
  • haematology (incl blood transfusion)
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Footnotes

  • Contributors The coauthors of this text have been in equal participation: MCCH, SGP and MCI. Also, MG has contributed in different ways in its elaboration.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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