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Occupational Medicine Advance Access published online on January 22, 2007
Occupational Medicine, doi:10.1093/occmed/kql162
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Pulmonary alveolar proteinosis induced by silica dust?

Riitta Sauni1, R Järvenpää2, E Iivonen3, S Nevalainen4 and J Uitti1

1 Finnish Institute of Occupational Health, Tampere, Finland and Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland
2 Department of Diagnostic Radiology, Tampere University Hospital, Tampere, Finland
3 Department of Pulmonary Diseases, Tampere University Hospital, Tampere, Finland
4 Suomen Terveystalo Group, Lahti, Finland

Abstract Pulmonary alveolar proteinosis (PAP) is a rare disease, with several aetiologies. This study reports the first Finnish case of PAP with possible induction by silica dust. A 58-year-old male patient had a documented history of heavy exposure to silica dust over a long period, although he himself considered the exposure to be low. The patient's cumulative exposure to silica dust was ~10 mg m–3 years according to the workplace measurements. The patient developed classical symptoms and signs of PAP that closely mimicked those of acute silicosis, but he did not have any signs of classic silicosis. We conclude that significant chronic exposure to silica favours the diagnosis of PAP rather than acute silicosis in this case. PAP should be taken into account when patients exposed to silica dust complain of respiratory symptoms. A patient's assessment of his/her exposure to silica may not always be reliable.

Keywords      Acute silicosis; exposure; lung disease; occupational disease; pulmonary alveolar proteinosis; silica

Correspondence to: Riitta Sauni, Finnish Institute of Occupational Health, PO Box 486, 33101 Tampere, Finland. Tel: +358 30 474 8650; fax: +358 30 474 8605; e-mail: riitta.sauni{at}ttl.fi


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