ERASMUS SYNDROME AS SILICON INDUCED FORM OF SYSTEMIC SCLEROSIS
Summary. We present a literature review and three own clinical observations of Erasmus syndrome (ES) in patients with systemic sclerosis (SSc). Regardless of the duration of SSc, ES develops in men who have had long professional respiratory contact with the quartz (silicon dioxide) in the manufacture, with such pulmonary pathology debut almost simultaneously with the formation of silicosis (anthracosilicosis) mutually exacerbating each other, often against a background of pre-existing tuberculosis, proceeds with reduced respiratory system function, increasing the silicon content in the hair and blood, accompanied by the activation of matrix metalloproteinases, the imbalance of cellular immunity with impaired cytokine network, overproduction of growth factors and a number of autoimmune disorders due to phagocytosis of quartz crystals by alveolar macrophages and fixing silicon on fibroblasts, which exacerbated with the pollution of the environment by the level of respirable silica in patients living areas. ES can be considered as a silicon induced form of professional SSc in men — scleroderma silicosis (anthracosilicosis), by analogy with Colin-Kaplan syndrome in patients with rheumatoid arthritis.
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