Complicated chronic silicosis: case report

Abstract

Introduction: silicosis is an irreversible pneumoconiosis caused by the prolonged inhalation of silica particles, leading to pulmonary fibrosis through the activation of lysosomal damage mechanisms and chronic inflammation. The diagnosis is made through a combination of clinical history, radiological findings, and histopathological studies.

Clinical case: a 31-year-old male patient with a history of eleven years working in a ceramics factory without respiratory protection measures. Initially diagnosed with upper respiratory infections, the progression of his respiratory symptoms led to a diagnosis of pulmonary fibrosis in August 2023. A video-assisted thoracic surgery (VATS) lung biopsy revealed granulomatous infiltrates. The computed tomography (CT) scan showed opacities, a reticulonodular pattern, and calcified mediastinal lymph nodes. Pulmonary function tests indicated a moderate to severe restrictive pattern. Histopathology confirmed the diagnosis of pneumoconiosis due to silicosis.

Conclusion: silicosis, resulting from prolonged exposure to silica in a ceramics factory, led to the development of pulmonary fibrosis with a severe restrictive pattern that significantly impacted the patient's quality of life. Treatment focused on eliminating silica exposure, preventive vaccination, and symptomatic management. Given that this was a young patient with advanced disease, lung transplantation was considered as a therapeutic option.