Korean J Occup Environ Med.  2008 Mar;20(1):46-53.

A Case of Goodpasture's Syndrome in a Foundry Worker

• Kim MG
• Koh DH
• Lee SW
• Jo MH
• Yoo HY
• Kim BY
• Lee JH

Abstract

BACKGROUND: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. CASE: A 46-year-old man, who had worked as a foundry worker for 27 years and had a 12 1/2 packyear history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA (0.0106 mg/m3), which was calibrated for overtime.
CONCLUSION
Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure.

Keyword

Goodpasture's syndrome; Silica; Foundry worker

MeSH Terms

Anti-Glomerular Basement Membrane Disease
Antibodies, Antineutrophil Cytoplasmic
Autoantibodies
Biopsy
Bronchoscopy
Chest Pain
Cough
Crystallins
Dyspnea
Glomerulonephritis
Granuloma
Hematuria
Hemorrhage
Humans
Hydrocarbons
Kidney
Lung
Middle Aged
Occupational Health
Plasmapheresis
Proteinuria
Renal Dialysis
Respiratory Tract Infections
Risk Factors
Silicon Dioxide
Smoke
Smoking
Threshold Limit Values
Tobacco Products
Urea
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Autoantibodies
Crystallins
Hydrocarbons
Silicon Dioxide
Smoke
Urea