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Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Author

Listed:
  • Joanna Hubska

    (Student Scientific Club “Endocrinus” Affiliated to Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland)

  • Urszula Shahnazaryan

    (Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland)

  • Marek Rosłon

    (Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland)

  • Benedykt Szczepankiewicz

    (Department of Pathology, Medical University of Warsaw, 7 Pawińskiego St., 02-106 Warsaw, Poland)

  • Kostiantyn Nikiforow

    (Institute of Physical Chemistry Polish Academy of Sciences, Kasprzaka 44/52 Str., 01-224 Warsaw, Poland)

  • Marcin Pisarek

    (Institute of Physical Chemistry Polish Academy of Sciences, Kasprzaka 44/52 Str., 01-224 Warsaw, Poland)

  • Małgorzata Barnaś

    (Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland)

  • Urszula Ambroziak

    (Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland)

Abstract

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.

Suggested Citation

  • Joanna Hubska & Urszula Shahnazaryan & Marek Rosłon & Benedykt Szczepankiewicz & Kostiantyn Nikiforow & Marcin Pisarek & Małgorzata Barnaś & Urszula Ambroziak, 2022. "Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report," IJERPH, MDPI, vol. 19(19), pages 1-6, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12921-:d:937154
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    References listed on IDEAS

    as
    1. Mar Requena-Mullor & Raquel Alarcón-Rodríguez & Tesifón Parrón-Carreño & Jose Joaquín Martínez-López & David Lozano-Paniagua & Antonio F. Hernández, 2021. "Association between Crystalline Silica Dust Exposure and Silicosis Development in Artificial Stone Workers," IJERPH, MDPI, vol. 18(11), pages 1-10, May.
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