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Miscellaneous |

The Malignant Silicosis of Stonecutters in Eastern Algeria FREE TO VIEW

Abdelmadjid Djebbar, PA; Souad Hamoud, PhD; Tarek Djenfi, PhD; Redha Selmani, PhD
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University of Batna and Hospital Public Establishment-Batna, Algeria, Batna, Algeria


Chest. 2015;148(4_MeetingAbstracts):657A. doi:10.1378/chest.2272358
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Abstract

SESSION TITLE: Miscellaneous Global Case Reports

SESSION TYPE: Global Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: Silicosis is a disease due to exposure to the dust of free crystalline silica (SiO2) wich accumulates over several years

CASE PRESENTATION: The authors report, through a series of 71 cases, severe form of the disease with pathological chest radiograph. It appeared in young men whose work was cutting and grooming stone without protection or adapted tools. The exposure time is rapidly debilitating not exceeding, in many cases, 10 months. Beyond the early onset of irreversible respiratory failure, the disease is characterized by a high rate of complications including tuberculosis, pneumothorax, respiratory secondary infections, chronic pulmonary heart disease, kidney failure and Systemic Diseases Thus we counted -29 Cases of tuberculosis, including pulmonary locations 24 and 5 Extra-pulmonary (3 lymph node, 2 pleura) with transition to antibiotic resistance in 11 of them. - 29 patients (%) presented pneumothorax, it is unilateral in 17 cases and bilateral in 12 others. those it is another source of decompensation and death in our series. - Respiratory superinfection was noted in 9 cases. - 2 patients complicated with chronic pulmonary heart after 4-6 years of occupational exposure. - 1 patient had an extracellular glomerulonephropathy with proliferative vascular injury & damage tubulointerstitial put on dialysis. - Finally, a systemic disease developed in 5 subjects: Caplan colinet (3 cases), Lupus (1 case), Erasmus syndrome (1 case). The progression of radiographic abnormalities and functional disorders has been extremely rapid in these autoimmune diseases associated with silicosis.

DISCUSSION: Our study shows: - The severity of occupational exposure to silica dust without protection. - The high assocoation cases of silico-tuberculosis progression toward resistance to therapeutic usual drugs. - The great frequency of occurrence of pneumothorax in our patients complicating their respiratory functional status Lethality in our series remains high. It involved 15 patients (21.12%). The death was secondary to multidrug-resistant tuberculosis in 5 cases, the pneumothorax (6 cases) and respiratory failure in 3 cases.

CONCLUSIONS: The inhalation of a big quantity of microscopic particles of silica dust , without any protection, promotes early onset of the disease in its rapidly incapacitating shape

Reference #1: CALVERT G.M., RICE F.R., BOIANO J.M., SHEEHY J.W., .T. 2003 , Occupational silica exposure and risk of various disease: an analysis using death cerificates from 2 states of United States. Occup. Environ. Medicine; 60; 122-129

Reference #2: JOCHI J.N., KNECHT D.A.2013. Silica phagocytosis causes apoptosis and necrosis by different temporal and molecular pathways in alveolar macrophages. Apoptosis; 18: 271-285.

DISCLOSURE: The following authors have nothing to disclose: Abdelmadjid Djebbar, Souad Hamoud, Tarek Djenfi, Redha Selmani

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