Tsuchiya Kazuo, Toyoshima Mikio, Fukada Atsuki, Akahori Daisuke, Funai Kazuhito, Suda Takafumi
Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Japan.
First Department of Surgery, Hamamatsu University School of Medicine, Japan.
Intern Med. 2018 May 1;57(9):1277-1280. doi: 10.2169/internalmedicine.9193-17. Epub 2017 Dec 27.
A 63-year-old man with occupational exposure to silica presented with cutaneous ulcer, pleuritic pain, and a fever. Laboratory data showed lymphopenia and positive serum antinuclear and anti-DNA antibodies. Computed tomography of the chest showed egg shell-like calcification of the hilar and mediastinal lymph nodes without pulmonary parenchymal involvement of silicosis. A surgical biopsy showed silicotic nodules with surrounding infiltration of lymphocytes and plasma cells in the parietal pleura. With a diagnosis of systemic lupus erythematosus (SLE), systemic corticosteroid therapy was given, which led to the resolution of symptoms and laboratory abnormalities. We discuss the relationship between silica exposure and the development of SLE.
一名63岁职业性接触二氧化硅的男性患者，出现皮肤溃疡、胸膜炎性疼痛和发热。实验室检查数据显示淋巴细胞减少，血清抗核抗体和抗DNA抗体呈阳性。胸部计算机断层扫描显示肺门和纵隔淋巴结呈蛋壳样钙化，无矽肺的肺实质受累。手术活检显示壁层胸膜有矽结节，周围有淋巴细胞和浆细胞浸润。诊断为系统性红斑狼疮（SLE）后，给予全身糖皮质激素治疗，症状和实验室异常情况得到缓解。我们讨论了二氧化硅暴露与SLE发生之间的关系。
