Asbestos related interstitial pneumonitis associated with glomerulonephritis and lymphomatoid granulomatosis

Our plain-English summary of Asbestos related interstitial pneumonitis associated with glomerulonephritis and lymphomatoid granulomatosis, by C.T. Cooke, L.R. Matz, J.A. Armstrong, et al (Pathology, 1986).

The study

• Authors: C.T. Cooke, L.R. Matz, J.A. Armstrong, R.F. Pinerua
• Journal: Pathology
• Published: 1986;18(3):352-6
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001198).

Abstract

We report a case of pulmonary asbestosis in a patient who also developed glomerulonephritis and lymphomatoid granulomatosis. The pulmonary reaction was unusual, characterized clinically by an acute onset of symptoms after a prolonged latent period and morphologically by an interstitial pneumonitis with prominent desquamative features and a paucity of fibrosis. The association of pulmonary asbestosis with glomerulonephritis and lymphomatoid granulomatosis has been hitherto unreported.

In plain English

This article was a case report from Royal Perth Hospital in Western Australia about one 46-year-old man. He had a history of severe, relatively unprotected asbestos exposure in the Wittenoom asbestos mines, where he had cleaned hoppers. Earlier chest X-rays had shown benign pleural plaques. He was admitted with a two-week history of productive cough, breathlessness and fever, and then developed respiratory failure that needed artificial ventilation. Tests for a range of infections were negative. A lung biopsy showed interstitial pneumonitis (inflammation of the lung tissue) with desquamative features, only very mild, patchy fibrosis, and many asbestos bodies. The asbestos fibre count was 101 million fibres per gram of dry lung tissue. The patient then developed protein in the urine and a rising serum creatinine. A kidney biopsy showed diffuse proliferative glomerulonephritis. It also showed a few structures in the kidney that looked identical to the uncoated asbestos fibres seen in the lung. The patient also had lymphomatoid granulomatosis, but most of that description is missing from the available text. The authors concluded that changes in organs other than the lung caused by migrating asbestos fibres appear relatively mild and probably of no functional significance.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 46-year-old man treated at Royal Perth Hospital, Perth, Western Australia
• Exposure: Severe, relatively unprotected occupational asbestos exposure in the Wittenoom asbestos mines, cleaning hoppers. The fibre type and the duration of exposure are not stated in the readable text. The authors place the illness some twenty-seven years after the exposure.
• Main results:
  • Earlier chest X-rays had shown benign pleural plaques and some basal nodularity
  • After admission the patient developed respiratory failure requiring intubation and artificial ventilation
  • The open lung biopsy showed interstitial pneumonitis with desquamative features and very mild, patchy interstitial fibrosis
  • The asbestos fibre count in the patient's lung was 1.01 × 10 to the 8th (101 million) asbestos fibres per gram of dry tissue
  • The kidney biopsy showed diffuse proliferative glomerulonephritis
  • Small rectilinear structures in the kidney's mesangial matrix were ultrastructurally identical to the uncoated asbestos bodies seen in the lung biopsy
  • Despite the very high fibre count in the lung, only a few uncoated asbestos fibres were detected in the kidney
  • A circulating IgM/IgG mixed cryoglobulin was found in the patient's serum
  • Deposits of tumour tissue were reported in the hilar lymph nodes and liver
• The authors' conclusion: The authors concluded that changes in organs other than the lung resulting from asbestos fibre migration and impaction appear relatively mild and probably of no functional significance
• Limitations the authors state:
  • The authors note that electron microscopy had not been performed in a group of cases they compared with, so a full comparison with this case was not possible. The surrounding context is missing from the text.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Interstitial, Pneumonitis, Asbestosis, Fibrosis.

Related studies

• Desquamative interstitial pneumonitis. Cellular phase of fibrosing alveolitis — R.R. Tubbs, S.P. Benjamin, et al. (1977)
• Low dose cabergoline induced interstitial pneumonitis — W. Frank, R. Moritz, et al. (1999)
• A potential cause of asbestos-related granulomatosis due to adulterant contamination in a drug abuser — M.C. Lazzaro, S. Romanò, et al. (2021)
• Lymphohistiocytoid mesothelioma: a rare lymphomatoid variant of predominantly sarcomatoid mesothelioma — D.W. Henderson, H.D. Attwood, et al. (1988)
• Physical activity in people with asbestos related pleural disease and dust-related interstitial lung disease: An observational study — M.T. Dale, Z.J. McKeough, et al. (2015)
• Agreement between chest radiography and high-resolution computed tomography in diagnosing dust-related interstitial lung fibrosis — R.R. Tiwari (2015)

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