Silicosis classification: Difference between revisions

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Latest revision as of 15:25, 8 June 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aparna Vuppala, M.B.B.S. [2]

Overview

There are 5 subtypes of silicosis that are differentiated according to the duration of exposure, development of symptoms, pulmonary function, and findings on chest imaging. Silicosis is classified as either simple chronic, complicated chronic, interstitial pulmonary fibrosis, accelerated silicosis, or acute silicosis.

Classification

There are 5 subtypes of silicosis that are differentiated according to the duration of exposure, development of symptoms, pulmonary function, and findings on chest imaging.^[1]

Simple Chronic

Respiratory disease often develops > 10 years following exposure to low - moderate concentrations of silica dust.
Patients usually remain asymptomatic, making the diagnosis of silicosis very difficult.
Pulmonary function tests are typically normal but may also be reduced.
On chest imaging, nodules are < 10 mm in diameter.

Complicated Chronic

Respiratory disease often develops > 10 years following exposure to silica dust.
Patients may report dyspnea and cough.
Pulmonary function may be either normal or reduced.
On chest imaging, nodules > 1 cm with either obstructive or restrictive changes of variable severity

Interstitial Pulmonary Fibrosis

Respiratory disease often develops > 10 years following exposure to silica dust.
Patients may report dyspnea and cough.
Pulmonary function may be either normal or reduced.
On chest imaging, diffuse reticulonodular pattern similar to idiopathic pulmonary fibrosis is usually observed.

Accelerated Silicosis

Respiratory disease often develops 5 to 10 years following exposure to silica dust.
Patients often report dyspnea, weakness, and weight loss.
Pulmonary function is often reduced with rapid deterioration of FVC and FEV1.
On chest imaging, rapidly progressive nodules and masses are observed.

Acute Silicosis

Respiratory disease often develops within 5 years of exposure to extremely high concentrations of silica dust.
Patients often report severe, disabling dyspnea, weakness, weight loss, and progressive respiratory failure.
Pulmonary function is usually reduced with restrictive changes and reduced diffusion capacity.
On chest imaging, bilateral perihilar acinar-pattern consolidations with ground glass appearance is observed.

References

↑ Fernández Álvarez R, Martínez González C, Quero Martínez A, Blanco Pérez JJ, Carazo Fernández L, Prieto Fernández A (2015). "Guidelines for the diagnosis and monitoring of silicosis". Arch Bronconeumol. 51 (2): 86–93. doi:10.1016/j.arbres.2014.07.010. PMID 25479706.

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[pmid25479706-1] Fernández Álvarez R, Martínez González C, Quero Martínez A, Blanco Pérez JJ, Carazo Fernández L, Prieto Fernández A (2015). "Guidelines for the diagnosis and monitoring of silicosis". Arch Bronconeumol. 51 (2): 86–93. doi:10.1016/j.arbres.2014.07.010. PMID 25479706.

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Silicosis}}
-{{CMG}}
+{{CMG}} {{AE}} {{AV}}
 ==Overview==
+There are 5 subtypes of silicosis that are differentiated according to the duration of exposure, development of symptoms, pulmonary function, and findings on chest imaging. Silicosis is classified as either simple chronic, complicated chronic, interstitial pulmonary fibrosis, accelerated silicosis, or acute silicosis.
 ==Classification==
-Classification of silicosis is made according to the disease's severity, onset, and rapidity of progression.  These include:
+There are 5 subtypes of silicosis that are differentiated according to the duration of exposure, development of symptoms, pulmonary function, and findings on chest imaging.<ref name="pmid25479706">{{cite journal| author=Fernández Álvarez R, Martínez González C, Quero Martínez A, Blanco Pérez JJ, Carazo Fernández L, Prieto Fernández A| title=Guidelines for the diagnosis and monitoring of silicosis. | journal=Arch Bronconeumol | year= 2015 | volume= 51 | issue= 2 | pages= 86-93 | pmid=25479706 | doi=10.1016/j.arbres.2014.07.010 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25479706  }} </ref>
+===Simple Chronic===
-* ''Chronic silicosis''
+*Respiratory disease often develops > 10 years following exposure to low - moderate concentrations of silica dust.
-Occurs after 15-20 years of exposure to moderate to low levels of silica dust.  Chronic silicosis itself is further subdivided into simple and complicated silicoses. This is the most common type of silicosis.  Patients with this type of silicosis may not have obvious symptoms, so a chest X-ray is necessary to determine if there is lung damage.
+*Patients usually remain asymptomatic, making the diagnosis of silicosis very difficult.
+*Pulmonary function tests are typically normal but may also be reduced.
-* ''Asymptomatic silicosis''
+*On chest imaging, [[nodules]] are < 10 mm in diameter.
-Early cases of the disease do not present any symptoms
-* ''Accelerated silicosis''
+===Complicated Chronic===
-Silicosis that develops 5-10 years after high exposure to silica dust.  Symptoms include severe shortness of breath, weakness, and weight loss.
+*Respiratory disease often develops > 10 years following exposure to silica dust.
+*Patients may report [[dyspnea]] and [[cough]].
+*[[Pulmonary function tests|Pulmonary function]] may be either normal or reduced.
+*On chest imaging, nodules > 1 cm with either obstructive or restrictive changes of variable severity
-* ''Acute silicosis''
+===Interstitial Pulmonary Fibrosis===
-Silicosis that develops a few months to 2 years after exposure to very high concentrations of silica dust.  Symptoms of acute silicosis include severe disabling shortness of breath, weakness, and weight loss, often leading to death.
+*Respiratory disease often develops > 10 years following exposure to silica dust.
+*Patients may report [[dyspnea]] and [[cough]].
+*Pulmonary function may be either normal or reduced.
+*On chest imaging, diffuse reticulonodular pattern similar to [[idiopathic pulmonary fibrosis]] is usually observed.
+===Accelerated Silicosis===
+*Respiratory disease often develops 5 to 10 years following exposure to silica dust.
+*Patients often report [[dyspnea]], [[weakness]], and [[weight loss]].
+*Pulmonary function is often reduced with rapid deterioration of [[FVC]] and [[FEV1]].
+*On chest imaging, rapidly progressive nodules and masses are observed.
-:*Simple chronic >10 years Nodules <10 mm Nosymptoms and Normal pulmonary function
+===Acute Silicosis===
-:*Complicated chronic >10 years , nodules >1 cm Dyspnea and Cough , Obstructive or restrictive changes, variable severity
+*Respiratory disease often develops within 5 years of exposure to extremely high concentrations of silica dust.
+*Patients often report severe, disabling [[dyspnea]], [[weakness]], [[weight loss]], and progressive respiratory failure.
-:*Interstitial pulmonary fibrosis >10 years , Diffuse reticulonodular pattern  symptoms Dyspnea, Cough , Restrictive changes with reduced diffusion capacity ,the main symptom is dyspnea. Radiological findings are very similar to those of idiopathic pulmonary fibrosis (IPF). Not much information is available on this form of the disease, but a recent study reported an incidence of 11% of pneumoconiosis cases with radiological findings interpreted as IPF.<ref name="pmid17400659">{{cite journal| author=Arakawa H, Johkoh T, Honma K, Saito Y, Fukushima Y, Shida H et al.| title=Chronic interstitial pneumonia in silicosis and mix-dust pneumoconiosis: its prevalence and comparison of CT findings with idiopathic pulmonary fibrosis. | journal=Chest | year= 2007 | volume= 131 | issue= 6 | pages= 1870-6 | pmid=17400659 | doi=10.1378/chest.06-2553 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17400659  }} </ref>
+*Pulmonary function is usually reduced with restrictive changes and reduced diffusion capacity.
+*On chest imaging, bilateral perihilar acinar-pattern [[consolidations]] with [[ground glass appearance]] is observed.
-:*Accelerated 5–10 years Rapidly progressing nodules and masses Dyspnea, Cough Rapidly deteriorating lung function (FVC and FEV1) This is an intermediate entity between the acute and the chronic forms that generally appears after a period of exposure of 5– 10 years and progresses more often and more rapidly to complicated forms.<ref name="pmid11836467">{{cite journal| author=Park R, Rice F, Stayner L, Smith R, Gilbert S, Checkoway H| title=Exposure to crystalline silica, silicosis, and lung disease other than cancer in diatomaceous earth industry workers: a quantitative risk assessment. | journal=Occup Environ Med | year= 2002 | volume= 59 | issue= 1 | pages= 36-43 | pmid=11836467 | doi= | pmc=PMC1740205 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11836467  }} </ref>, <ref name="pmid17976433">{{cite journal| author=Greenberg MI, Waksman J, Curtis J| title=Silicosis: a review. | journal=Dis Mon | year= 2007 | volume= 53 | issue= 8 | pages= 394-416 | pmid=17976433 | doi=10.1016/j.disamonth.2007.09.020 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17976433  }} </ref>
-:*Acute(silico proteinosis) <5 years Bilateral acinar pattern similar to alveolar proteinosis Dyspnea Generally restrictive changes with reduced diffusion capacity Extremely high levels of silica exposure can result in the rapid appearance of silicoproteinosis or accelerated silicosis.Acute silicosis is generally caused by massive exposure. It is similar to alveolar proteinosis, and presents with dyspnea, weight loss and progressive respiratory failure.18Bilateral perihilar consolidations similar to alveolar proteinosis are seen on chest X-rays, and high resolution computed tomography (HRCT) reveals ground glass opacities or air space consolidations.
 ==References==
 {{Reflist|2}}
-[[Category:Needs content]]
 [[Category:Pulmonology]]
-[[Category:Occupational diseases]]
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