KMID : 0358520080200010046
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Korean Journal of Occupational and Environmental Medicine 2008 Volume.20 No. 1 p.46 ~ p.53
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A Case of Goodpasture¡¯s Syndrome in a Foundry Worker
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Kim Min-Gi
Koh Dong-Hee Lee Sun-Wung Jo Min-Heui Yoo Hee-Yong Kim Bo-Yeon Lee June-Hyuk
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Abstract
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Background: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known
as risk factors of Goodpasture¡¯s syndrome. We studied a patient with Goodpasture¡¯s syndrome who had
worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome,
we describe and discuss our study results.
Case: A 46-year-old man, who had worked as a foundry worker for 27 years and had a 12 1/2 packyear
history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing,
chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function
disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed
ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomerulonephritis.
Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at
lung biopsy. Finally, we diagnosed the worker¡¯s illness as Goodpasture¡¯s syndrome and carried out
hemodialysis and plasmapheresis.
In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA
(0.0106 mg/m3), which was calibrated for overtime.
Conclusion: Based on both the clinical test and industrial hygiene examination, we concluded that the
Goodpasture¡¯s syndrome in this case was caused by long-term silica exposure.
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KEYWORD
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Goodpasture¡¯s syndrom, Silica, Foundry worker
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