SILICOSIS DUE TO INTENTIONAL INHALATION O F SCOURING POWDER

A case of acute silicosis due to intentional inhalation of the scourin g powder Ajax(R) in a female patient suffering a sickle-cell trait (30 % of S haemoglobin) is reported. It consisted of an acute immuno-alle rgic pneumonitis with fever and a respiratory distress-syndrome. It wa s associated with a severe biological inflammatory syndrome and immuno logical disturbances with circulating immune complexes and antinuclear antibodies. The assessment of respiratory function demonstrated the p resence of a restrictive syndrome with hypoxaemia and decreased CO tra nsfer. The anatomopathological and mineralogical exams confirmed the d iagnosis of silicosis and elicited birefringent particles in polarized light, some nodules. interstitial fibrosis and proteic deposits in fa vour of alveolar lipoproteinosis. The treatment included mechanical ve ntilation with PEEP, antibiotics and corticosteroids. Two pulmonary la vages were performed. The patient died of septic shock before a lung t ransplantation could be obtained.