Sarcoid-like Lung Disease as a Reaction to Silica from Exposure to Bentonite Cat Litter Complicated by End-Stage Renal Failure—A Case Report

Joanna Hubska, Urszula Shahnazaryan, Marek Rosłon, Benedykt Szczepankiewicz, Kostiantyn Nikiforow, Marcin Pisarek, Małgorzata Barnaś and Urszula Ambroziak ()
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Joanna Hubska: Student Scientific Club “Endocrinus” Affiliated to Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
Urszula Shahnazaryan: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
Marek Rosłon: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
Benedykt Szczepankiewicz: Department of Pathology, Medical University of Warsaw, 7 Pawińskiego St., 02-106 Warsaw, Poland
Kostiantyn Nikiforow: Institute of Physical Chemistry Polish Academy of Sciences, Kasprzaka 44/52 Str., 01-224 Warsaw, Poland
Marcin Pisarek: Institute of Physical Chemistry Polish Academy of Sciences, Kasprzaka 44/52 Str., 01-224 Warsaw, Poland
Małgorzata Barnaś: Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland
Urszula Ambroziak: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 19, 1-6

Abstract: A 44-year-old woman was admitted to hospital with end-stage renal failure, productive cough, and decreased exercise tolerance. She had owned nine cats, which resulted in long-term exposure (18 years) to silica-containing bentonite cat litter. High-resolution computed tomography of the chest showed micronodular lesions in the lungs, and mild mediastinal lymphadenopathy. A lung biopsy revealed multinucleated giant cells, some of which had birefringent material and Schaumann bodies. X-ray photoelectron spectroscopy revealed the presence of silicon in the lung biopsy specimen, as well as in the patient’s cat litter. The pulmonary condition was suggestive of sarcoid-like lung disease, rather than silicosis, sarcoidosis, or hypersensitivity pneumonitis, according to the clinicopathological findings. Renal failure appeared to be a result of chronic hypercalcemia due to extrarenal calcitriol overproduction in activated alveolar macrophages. Ultimately, the patient was diagnosed with sarcoid-like lung disease complicated by end-stage renal failure from exposure to bentonite cat litter. Therapy with steroids, in addition to elimination of the bentonite cat litter exposure, resulted in a significant improvement in the health condition. At a follow-up visit after 4 months, an almost complete resolution of the lung lesions and a significant improvement in renal function were observed.

Keywords: sarcoid-like lung disease; bentonite cat litter; silica-related disease; end-stage renal failure (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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