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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

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 m...

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Autores principales: Hubska, Joanna, Shahnazaryan, Urszula, Rosłon, Marek, Szczepankiewicz, Benedykt, Nikiforow, Kostiantyn, Pisarek, Marcin, Barnaś, Małgorzata, Ambroziak, Urszula
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566682/
https://www.ncbi.nlm.nih.gov/pubmed/36232221
http://dx.doi.org/10.3390/ijerph191912921
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author Hubska, Joanna
Shahnazaryan, Urszula
Rosłon, Marek
Szczepankiewicz, Benedykt
Nikiforow, Kostiantyn
Pisarek, Marcin
Barnaś, Małgorzata
Ambroziak, Urszula
author_facet Hubska, Joanna
Shahnazaryan, Urszula
Rosłon, Marek
Szczepankiewicz, Benedykt
Nikiforow, Kostiantyn
Pisarek, Marcin
Barnaś, Małgorzata
Ambroziak, Urszula
author_sort Hubska, Joanna
collection PubMed
description 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.
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spelling pubmed-95666822022-10-15 Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report Hubska, Joanna Shahnazaryan, Urszula Rosłon, Marek Szczepankiewicz, Benedykt Nikiforow, Kostiantyn Pisarek, Marcin Barnaś, Małgorzata Ambroziak, Urszula Int J Environ Res Public Health Case Report 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. MDPI 2022-10-09 /pmc/articles/PMC9566682/ /pubmed/36232221 http://dx.doi.org/10.3390/ijerph191912921 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Hubska, Joanna
Shahnazaryan, Urszula
Rosłon, Marek
Szczepankiewicz, Benedykt
Nikiforow, Kostiantyn
Pisarek, Marcin
Barnaś, Małgorzata
Ambroziak, Urszula
Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title_full Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title_fullStr Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title_full_unstemmed Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title_short Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report
title_sort sarcoid-like lung disease as a reaction to silica from exposure to bentonite cat litter complicated by end-stage renal failure—a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566682/
https://www.ncbi.nlm.nih.gov/pubmed/36232221
http://dx.doi.org/10.3390/ijerph191912921
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