Renal involvement in a silicosis patient - case report and literature review

A 43-year-old Chinese man with a silicosis history was admitted to our hospital due to bilateral lower extremity edema for 1 year, exacerbating with hematuria for 2 months. He started working as a coal miner 30 years ago, and was diagnosed as silicosis 3 months ago. Lab tests revealed hematuria 3+,...

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Bibliographic Details
Published in:Renal failure 2019-01, Vol.41 (1), p.1045-1053
Main Authors: Chen, Fei-Fei, Tang, Hai-Yan, Yu, Feng, Que, Cheng-Li, Zhou, Fu-de, Wang, Su-Xia, Wang, Guang-Fa, Zhao, Ming-Hui
Format: Article
Language:English
Subjects:
Adult
Apoptosis
Biopsy
Blood
Case reports
Caspase-1
Clinical Study
Collagen
Corticosteroids
Creatinine
Critical care
Cytokines
Disease control
Edema
Hematuria
Hospitals
Humans
IgA nephropathy
Immunoglobulin A
Interleukin 18
Kidney - metabolism
Kidney - ultrastructure
Kidney diseases
Kidney Diseases - etiology
Kidney Diseases - metabolism
Kidney Diseases - pathology
Laboratories
Literature reviews
Macrophages
Male
MARCO protein
MARCO receptor
Medicine
Microscopy
Nephritis
NLR Family, Pyrin Domain-Containing 3 Protein - metabolism
Proteins
Proteinuria
Pyrin protein
Remission
Silica
silica nephropathy
Silicosis
Silicosis - complications
Silicosis - metabolism
the NLRP3 inflammasome
Ultrasonic imaging
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Summary:A 43-year-old Chinese man with a silicosis history was admitted to our hospital due to bilateral lower extremity edema for 1 year, exacerbating with hematuria for 2 months. He started working as a coal miner 30 years ago, and was diagnosed as silicosis 3 months ago. Lab tests revealed hematuria 3+, proteinuria 3+, and a serum creatinine value 2.47 mg/dl on routine check. He was diagnosed with focal proliferative IgA nephropathy (IgAN) and acute tubulo-interstitial nephritis by renal biopsy. He was treated with corticosteroids and got a remission 4 months later. Immunohistochemical staining showed the deposition of macrophage receptor with collagenous structure (MARCO), nod-like receptor pyrin domain-containing-3 (NLRP3), Caspase-1, apoptosis-associated speck (ASC), interleukin (IL)-1β, and IL-18 in both glomerular and tubulo-interstitial areas. We proposed that the silicon exposure could be related to his kidney disease in the patient and NLRP3 mediated inflammation might be involved in its pathogenesis which needs further explorations.
ISSN:0886-022X
1525-6049
DOI:10.1080/0886022X.2019.1696209