Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
Bibliographic Data
| ID | 15470599 |
|---|---|
| Authors | Joanna Hubska (0000-0002-9993-5708, Medical University of Warsaw), Urszula Shahnazaryan (Medical University of Warsaw), Marek Rosłon (Medical University of Warsaw), Benedykt Szczepankiewicz (Medical University of Warsaw), Kostiantyn Nikiforow (0000-0001-6135-8514, Institute of Physical Chemistry), Marcin Pisarek (0000-0002-7424-5954, Institute of Physical Chemistry), Małgorzata Barnaś (0000-0003-3545-8401, Medical University of Warsaw), Urszula Ambroziak (0000-0002-8778-1959, Medical University of Warsaw, corresponding author) |
| Year | 2022 |
| Volume | 19 |
| Issue | 19 |
| Pages | 12921-12921 |
| Publication date | 2022-10-09 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Environmental Research and Public Health (JOURNAL) |
| Journal identifiers | ISSN: 1661-7827 • E-ISSN: 1660-4601 |
| Publisher | Multidisciplinary Digital Publishing Institute (PUBLISHER • CH) |
| DOI | 10.3390/ijerph191912921 |
| PMID | 36232221 |
| OpenAlex | W4303946700 |
| Language | EN |
| References cited | 19 |
A 44-year-old woman was admitted to hospital with end-stage renal failure, productive cough, and decreased exercise tolerance. She had owned nine cats, which resulted in long-term exposure (18 years) to silica-containing bentonite cat litter. High-resolution computed tomography of the chest showed micronodular lesions in the lungs, and mild mediastinal lymphadenopathy. A lung biopsy revealed multinucleated giant cells, some of which had birefringent material and Schaumann bodies. X-ray photoelectron spectroscopy revealed the presence of silicon in the lung biopsy specimen, as well as in the patient's cat litter. The pulmonary condition was suggestive of sarcoid-like lung disease, rather than silicosis, sarcoidosis, or hypersensitivity pneumonitis, according to the clinicopathological findings. Renal failure appeared to be a result of chronic hypercalcemia due to extrarenal calcitriol overproduction in activated alveolar macrophages. Ultimately, the patient was diagnosed with sarcoid-like lung disease complicated by end-stage renal failure from exposure to bentonite cat litter. Therapy with steroids, in addition to elimination of the bentonite cat litter exposure, resulted in a significant improvement in the health condition. At a follow-up visit after 4 months, an almost complete resolution of the lung lesions and a significant improvement in renal function were observed
Lung · Pathology · Sarcoidosis · Silicosis · Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis · Medicine · Occupational and environmental lung diseases · Sarcoidosis and Beryllium Toxicity Research · Gastroenterology · Internal Medicine
| Highly cited | No |
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