Case ReportSystemic Iron Overload Associated with Welder’s Siderosis
Section snippets
CASE 1
A 40-year-old man presented with persistent fatigue and intermittent chest pains. He was a smoker who had been averaging 1 ½ packs of cigarettes per day for over 25 years. Twenty-one months before, he was admitted to another hospital with bilateral pleuritic chest pain. His inpatient evaluation included a computed tomographic (CT) scan of the chest that revealed bilateral pulmonary infiltrates characterized by poorly defined centrilobular micronodules without associated intrathoracic
CASE 2
A 52-year-old man presented for evaluation of bilateral lung infiltrates noted incidentally during a preoperative evaluation for hand surgery (debridement of a finger infection). He had been a welder for 23 years. He denied any respiratory symptoms including cough, shortness of breath, expectoration, fever, chills, and weight loss. He was a smoker with a 68 pack-years smoking history. There was no history of hematologic disorders or transfusions. His physical examination was notable for
DISCUSSION
Welder’s pneumoconiosis was first described in 1936 by Doig and McLaughlin6 and in most cases represents pulmonary siderosis caused by chronic inhalation of welding fumes.1., 2., 3., 4., 5. The chief component of fumes resulting from most welding processes is iron oxide. Pulmonary siderosis results from deposition of iron in the lung which is partly ingested by alveolar macrophages. It is generally considered a benign condition.1., 2., 3.
Although the association of welding and pulmonary
CONCLUSION
Both of our patients had CT findings and histopathologic features documented by lung biopsy of welder’s siderosis that was associated with evidence for systemic iron overload. There was no evidence of genetic hemochromatosis or other identifiable cause for iron overload aside from chronic welding exposure. We conclude that welder’s lung (siderosis) can be associated systemic iron overload from chronic inhalation of iron particles. Welding maybe an under-recognized source of systemic iron
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2021, Ecotoxicology and Environmental SafetyCitation Excerpt :The transition metals on the surface of the particles can also generate ROS through the Fenton reaction and lead to oxidative damage in the DNA (Vidrio et al., 2008). Particles released during welding have different diameters, but the majority are less than 2.5 µm, including nanoparticles, which can reach the alveoli and deposit there, generating interstitial fibrosis and eventually, respiratory diseases such as bronchitis, airway irritation, lung function changes (Antonini, 2003), siderosis (Patel et al., 2009), asthma (Storaas et al., 2015), COPD (Ithnin et al., 2019) and lung cancer (Honaryar et al., 2019; Wong et al., 2017). Studies have described that these nanoparticles are rich in different metals (McCarrick et al., 2019; Shoeb et al., 2017).
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