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Tunnel excavation triggering pulmonary sarcoidosis
Author(s) -
KawanoDourado L.B.,
Carvalho C.R.R.,
Santos U.P.,
Canzian M.,
Coletta E.N.A.,
Pereira C.A.C.,
Kairalla R.A.
Publication year - 2012
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.21030
Subject(s) - sarcoidosis , medicine , context (archaeology) , chest radiograph , pneumoconiosis , presentation (obstetrics) , dermatology , lung , surgery , pathology , paleontology , biology
Context A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. Case Presentation A 22‐year‐old male non‐smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non‐caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. Discussion Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications. Am. J. Ind. Med. 55:390–394, 2012. © 2011 Wiley Periodicals, Inc.