SILICOSIS AND ITS ASSOCIATION WITH AUTOIMMUNITY: THREE CASES SILICOSIS-RELATED ANCA VASCULITIS
Dr CAMERON BURNETT1, Dr MURTHY DIVI2, Dr YUSUF EQBAL2, Dr DWARAKANATHAN RANGANATHAN1, Dr ALAN PARNHAM1
1Kidney Health Service, Royal Brisbane and Women’s Hopsital, QLD, Australia, Brisbane, Australia, 2Department of Nephrology, Gold Coast University Hospital, QLD, Australia, Gold Coast, Australia
There is growing interest in the association between Silicosis and the development of ANCA and other autoantibody induced vasculitis. Silicosis is a fibrotic lung disease, developing because of occupational inhalation of respirable crystalline silicon dioxide particles across many industries including construction, mining and automobile repairs. A growing body of evidence across in vitro and animal studies suggests that dysfunctional adaptive immune responses to the presence of silica could be responsible for the development of a variety of autoantibodies including ANCA. Here we describe three cases of middle-aged men from Queensland, Australia, all who were diagnosed with Silicosis and subsequently developed aggressive forms of ANCA vasculitis in the decades following their diagnosis. Each had worked in occupational hazards with chronic exposure to silica dust. We outline the clinical phenotypes of each case and their response to standard vasculitic treatment in the setting of silicosis. We contextualise these results by providing a narrative review of the natural history, pathophysiology, and discuss unique management considerations for this unfortunate situation.
Biography:
Dr Cameron Burnett is a Kidney Advanced Trainee at the RBWH, Queensland. Dr Burnett is a clinician-researcher presently involved in glomerulonephritis, home therapies and quality of life in patients with CKD. He plans to validate a Life Participation outcome measure during his PhD at the University of Queensland, and develop strategies to improve life goal attainment in CKD. Undertaking a Masters of Public health in Healthcare Redesign, he is interested in education and leadership. He graduated from the University of Tasmania in 2016 after being awarded 1st Class Honours for in vitro research into dysfunctional inflammatory responses with ageing. He enjoys free time with his beautiful wife and two daughters.