Acta Biomedica Scientifica (Aug 2021)
Silicoarthritis: issues of early diagnosis, prevention
Abstract
Background. The severity of the course of silicosis is aggravated by the addition of complications; one of the serious and rare complication of silicosis is silicoarthritis or Kaplan’s syndrome (KS), which accounts for 0.1-0.6% of all cases of silicosis. Silicoarthritis significantly reduces the quality of the life of patients and leads to early and persistent disability.Aim. To establish the most significant methods of diagnosing silicoarthritis for early detection of the disease and prevention of complications.Materials and methods. The article presents clinical cases of silicosis and its rare complication - SC. The basis for the diagnosis of this pathology is X-ray, immunological and functional methods.Results. In patients with more than 5 years of experience exposed to aerosols of fibrogenic action, crystalline silicon dioxide, with an excess of the MPC level from 2.3 to 4 times on the basis of MSCT of the lungs, during which multiple polymorphic foci with a diameter of 2 up to 10 mm, partly merging with each other into peribronchovascular couplings, as well as perifocal areas of reduced airiness like ground glass and thickening of the axial interstitium, a diagnosis of late silicosis, stage 2 nodular form was established, the diagnosis was confirmed by biopsy data. In dynamics, after 5 years, arthralgic complaints joined. On the basis of immunological (increased TNF-alpha, IL-1b), X-ray examination (osteoarthritis of the distal and proximal interphalangeal, wrist, metatarsophalangeal joints), the diagnosis was clarified as Silicoarthritis: Kaplan’s syndrome.Conclusion. Diagnosis of silicosis and its complications at the preclinical stage in workers who have been in contact with silica dust for 5 years or more should include: MSCT of the lungs, determination of TNF-alpha, IL-1b, rheumatoid factor, and a study of respiratory function.
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