Microscopic Polyangiitis Accompanied by Pleuritis as the only Pulmonary Manifestation of Occupational Silica Exposure

作者：Shibuya Hideki^*; Sano Hiroko; Osamura Kou; Kujime Kosei; Hara Kei; Hisada Tetsuya

来源：Internal Medicine, 2010, 49(10): 925-929.

DOI：10.2169/internalmedicine.49.3046

• myeloperoxidase anti-neutrophil cytoplasmic antibody
• silica
• silicosis
• vasculitis
• pleuritis
• occupational exposure

A 68-year-old man, who had worked for processing quartz-containing stones for more than 50 years, complained of low-grade fever and arthralgia. Mediastinal lymph nodes were markedly swollen on chest computed tomography. Pathological findings of the lymph node were compatible with silicosis, with a high titer of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). During follow-up with prednisolone treatment, pleuritis and uveitis developed as manifestations of vasculitis. Thus, he was diagnosed with MPO-ANCA-associated vasculitis with occupational silica exposure, possibly microscopic polyangiitis (MPA). This case is rare, because pleuritis was the only pulmonary manifestation, without interstitial pneumonia, alveolar hemorrhage or glomerulonephritis.

• 出版日期2010