Silica and glomerulonephritis: case report and review of the literature.
Osorio-AM; Thun-MJ; Novak-RF; Cura-EJ; Avner-ED
Am J Kidney Dis 1987 Mar; 9(3):224-230
A case of diffuse proliferative glomerulonephritis in a 54 year old male foundry worker with extensive silica exposure on the job was investigated and compared to reported animal studies and clinical case studies. The worker developed an aggressive nephrosis and renal failure over a 3 month period. He had worked for 15 years as a core maker for a steel foundry. Breathing zone free crystalline silica (14808607) concentrations for core makers at the foundry showed air levels up to 2.5 times the OSHA permissible exposure limit (PEL). He had used no respiratory protection at work. Laboratory tests confirmed the nephrotic syndrome in the absence of pulmonary effects. Polarized light microscopy showed the presence of silicon crystals in the kidneys. Toxicologic and medical literature was reviewed concerning the association between silica exposure and glomerulonephritis, both in occupationally exposed workers and in laboratory animals. Only one other case showed a lack of pulmonary involvement. Animal experiments demonstrating a variety of renal lesions in rats and rabbits following the injection or implantation of silica gel were also reviewed. The authors conclude that renal silica induced damage may precede pulmonary silica disease in some individuals.
NIOSH-Author; Nephrological-disorders; Silicosis; Humans; Laboratory-animals; Occupational-diseases; Kidney-disorders; Nephrotoxicity; Dust-exposure;
American Journal of Kidney Diseases