Diffuse Lung Disease |

Silico-Scleroderma: Report of a Case FREE TO VIEW

Raquel Aguirre*, MD; Lilian Capone, MD; Gabriela Tabaj, MD; Luciana Molinari, MD; Maria Otaola, MD; Silvia Quadrelli, PhD
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British Hospital, Buenos Aires, Argentina

Chest. 2012;142(4_MeetingAbstracts):461A. doi:10.1378/chest.1388787
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SESSION TYPE: ILD Global Case Report Posters

PRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM

INTRODUCTION: In 1957 Erasmus published the association between silicosis and the development of scleroderma with lung involvement in gold miners → Erasmus syndrome with an incidence ranging from 12 to 42% according to series published

CASE PRESENTATION: Male patient 40, with a history of systemic scleroderma (Anti SCl 70 (+), anticentromere (-) diagnosed 2007 with lung involvement from diagnosis of the disease, lung function test: FVC: 3.25 L (70% ) FEV1: 2.5 L (68%) FEV1/FVC: 77% DLCO: 19.2 (67%), for which he received treatment with cyclophosphamide monthly pulses (6 pulses) and meprednisona 10 mg / day. denies toxic history

DISCUSSION: Evolution: 2011: Consultation by weakness and muscle pain, with progressive dyspnea class IV and mucous expectoration. Physical examination. SO2.95% BEAB, ulcers, respiratory functional impairment dígitales.Con FVC: 2.58L (57%) DLCO: 14.8L (53%). With progression of pulmonary infiltrates and mediastinal lymphadenopathy calcified, making differential diagnoses proposed were sarcoidosis, silicosis, so we decided to perform surgical lung biopsy for definitive diagnosis Directed questioning: Work history: 13 to 15 years: Working in a sandblaster, unprotected 16 to 28 years: Administration of a Refrigerating, poultry 29 to 40 years: Administration of a pile of construction company Pathology report: - There is marked distortion of pulmonary architecture adopts an aspect of "honeycombing" with septal fibrous thickening, fibroblast foci and proliferation of smooth muscle strips. Coexisting type II pneumocytes hyperplasia and moderate inflammatory infiltrate predominantly lymphocytic. It also identifies subpleural nodules esclerohialinos type morphology - silicotic. Diagnosis: Table histopathological type interstitial pneumonia fund (IPU) and numerous predominantly subpleural silicotic nodules type

CONCLUSIONS: With this work, we emphasize the importance of occupational history in patients with scleroderma systemic, especially in males and pulmonary symptoms due to the possibility of association between the two diseases (silicoesclerodermia)

1) R L Cowie.Silica-dust-exposed mine workers with scleroderma (systemic sclerosis).Chest 1987;92;260-262

2) Eramus. LD scleroderma in gold- miners on the Witwatersrand with particular reference to pulmonary manisfestations S Afr J Lab Clin Med 1957, 3-209-31

3) Sluis- Cremer Gk, Hessel PA,Hnizdo E, Churchill AR. Silica, silicosis and progressive systemic sclerosis Br. J Ind Med 1985; 42: 838-43

DISCLOSURE: The following authors have nothing to disclose: Raquel Aguirre, Lilian Capone, Gabriela Tabaj, Luciana Molinari, Maria Otaola, Silvia Quadrelli

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British Hospital, Buenos Aires, Argentina




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