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Occupational Medicine 2004;54:265-267
Occupational Medicine, Vol. 54 No. 4 © Society of Occupational Medicine; all rights reserved

Case Report

Chronic overexposure to cadmium fumes associated with IgA mesangial glomerulonephritis

Santiago Nogué1, Pere Sanz-Gallén1, Albert Torras2 and Francisco Boluda1

1 Toxicology Unit, Hospital Clínic, Barcelona, Spain.
2 Nephrology Service, Hospital Clínic, Barcelona, Spain.

Background

Cadmium is a metal used in the zinc, copper and steel industries, and in the manufacture of electric batteries and solar cells. Acute cadmium poisoning is characterized by irritation of the respiratory tract, while in chronic poisoning the main target organ is the renal tubule.

Aims

We report a patient with chronic work overexposure to cadmium, who presented a IgA mesangial glomerulonephritis with no respiratory or renal tubule involvement.

Case report

A 39-year-old patient was referred to our hospital for evaluation of a glomerular nephropathy. For the past 12 years he had worked as a welder, using cadmium elec- trodes. The patient had no respiratory symptoms and the chest X-ray was normal. Tests showed a proteinuria of 2 g in 24 h with microhaematuria [150 red blood cells/high power field (rbc/hpf)], with preservation of the renal function (creatinine clearance of 137 ml/min). The concentrations of cadmium in blood and urine were 45 µg/l and 25 µg/g creatinine, and an environmental study showed that levels of cadmium in the workplace were 52 µg/m3. A renal biopsy showed an IgA mesangial glomerulonephritis. The patient ceased to work with cadmium, and 1 year later cadmium levels had decreased and renal function was found to be stable.

Conclusions

IgA mesangial glomerulonephritis is a disease of unknown aetiology which has been associated with other diseases. Chronic overexposure to cadmium may contribute to the development of this nephrophathy.

Keywords      Cadmium exposure; IgA mesangial glomerulonephritis

Received        7 July 2003
Revised          6 January 2004
Accepted       19 January 2004

Correspondence to: Dr Pere Sanz-Gallén, Ronda del General Mitre no. 39, 08017-Barcelona, Spain. e-mail: 17039psg{at}comb.es


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