[Acute silicosis caused by intentional inhalation of scouring powder]

A case of acute silicosis due to intentional inhalation of the scouring powder Ajax in a female patient suffering a sickle-cell trait (30% of S haemoglobin) is reported. It consisted of an acute immuno-allergic pneumonitis with fever and a respiratory distress syndrome. It was associated with a severe biological inflammatory syndrome and immunological disturbances with circulating immune complexes and antinuclear antibodies. The assessment of respiratory function demonstrated the presence of a restrictive syndrome with hypoxaemia and decreased CO transfer. The anatomopathological and mineralogical exams confirmed the diagnosis of silicosis and elicited birefringent particles in polarized light, some nodules, interstitial fibrosis and proteic deposits in favour of alveolar lipoproteinosis. The treatment included mechanical ventilation with PEEP, antibiotics and corticosteroids. Two pulmonary lavages were performed. The patient died of septic shock before a lung transplantation could be obtained.