Abstract
A 57-year-old male who had been working in masonry for 33 years was hospitalized for renal function decline associated with exertional dyspnea. He presented with hypertension and limb edema. Urinalysis revealed an active urine sediment with glomerular proteinuria at 1.5 g/24h and the renal biopsy identified mesangial IgA Nephropathy. Chest tomography scans showed signs of silicosis. The patient received Angiotensin-Converting Enzyme Inhibitors with stable renal function. To our knowledge, the association of silicosis-IgA nephropathy has rarely been reported in the literature. This case highlights the effect of chronic exposure to silica dust and its association with both silica and renal disease.
Highlights
Occupational exposure to crystalline silica dust particles may lead to silicosis, which is the most common pneumoconiosis
The most common silica nephropathies described to be related to silicosis are crescentic glomerulonephritis, proliferative glomerulonephritis and chronic interstitial nephritis.[1]
Silicosis-IgA nephropathy (IgA N) is a rare association and very few cases have been reported in the literature.[2,3,4,5,6]
Summary
Occupational exposure to crystalline silica dust particles may lead to silicosis, which is the most common pneumoconiosis. We report the case of a mason with a coexistent silicosis and IgA nephropathy in order to better understand such association. The professional anamneses revealed that the patient worked as a mason for 33 years in several constructions and public work companies. He was responsible of supervising concreting, masonry, foundations, walls and floors covering as well as painting and finishing. Chest tomography was performed and it revealed fibrosing diffuse interstitial lung disease consisting of bilateral septal thickening, ground-glass opacities and a honeycomb pattern. These aspects predominated at the two bases and on the periphery (Figure 2). From a medico-legal point of view, silicosis is considered as a compensable occupational disease, according to the Tunisian list table of occupational diseases.[7]
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