Daize E, Marti-Flich J, Palmier B, Escarment J
Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Desgenettes, Lyon.
Ann Fr Anesth Reanim. 1994;13(2):251-4. doi: 10.1016/s0750-7658(05)80559-3.
A case of acute silicosis due to intentional inhalation of the scouring powder Ajax in a female patient suffering a sickle-cell trait (30% of S haemoglobin) is reported. It consisted of an acute immuno-allergic pneumonitis with fever and a respiratory distress syndrome. It was associated with a severe biological inflammatory syndrome and immunological disturbances with circulating immune complexes and antinuclear antibodies. The assessment of respiratory function demonstrated the presence of a restrictive syndrome with hypoxaemia and decreased CO transfer. The anatomopathological and mineralogical exams confirmed the diagnosis of silicosis and elicited birefringent particles in polarized light, some nodules, interstitial fibrosis and proteic deposits in favour of alveolar lipoproteinosis. The treatment included mechanical ventilation with PEEP, antibiotics and corticosteroids. Two pulmonary lavages were performed. The patient died of septic shock before a lung transplantation could be obtained.
报告了一例患有镰状细胞性状（血红蛋白S占30%）的女性患者因故意吸入洁星擦洗粉而导致急性矽肺的病例。该病例表现为伴有发热的急性免疫过敏性肺炎和呼吸窘迫综合征。它与严重的生物炎症综合征以及伴有循环免疫复合物和抗核抗体的免疫紊乱有关。呼吸功能评估显示存在伴有低氧血症和一氧化碳转运减少的限制性综合征。解剖病理学和矿物学检查证实了矽肺的诊断，并在偏振光下发现了双折射颗粒、一些结节、间质纤维化以及有利于肺泡蛋白沉积症的蛋白质沉积物。治疗包括使用呼气末正压通气的机械通气、抗生素和皮质类固醇。进行了两次肺灌洗。患者在能够进行肺移植之前死于感染性休克。
