Case Report
Microscopic Polyangiitis Secondary to Silica Exposure
Poliangitis microscópica secundaria a exposición a sílice
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=> array:3 [ "nombre" => "Javier Darío" "apellidos" => "Márquez Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "Carlos Jaime" "apellidos" => "Velásquez Franco" "email" => array:2 [ 0 => "carjaivel@hotmail.com" 1 => "carjaivel@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Medicina Interna, Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Grupo de Reumatología, Hospital Pablo Tobón Uribe, Medellín, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Facultad de Medicina, Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Poliangitis microscópica secundaria a exposición a sílice" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 676 "Ancho" => 900 "Tamanyo" => 143356 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Renal biopsy evidence of glomerulonephritis with segmental necrotizing extracapillary proliferation (long arrow) with marked interstitial fibrosis and tubular atrophy (short arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Silica exposure has been linked to autoimmune diseases (rheumatoid arthritis, systemic sclerosis, Sjogren's syndrome, and sarcoidosis).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> An association has been described between this mineral and the presence of ANCA but, to the best of our knowledge, there are no conclusive reports of induction of systemic vasculitis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Observation</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 34-year-old male who, for the past 6 years, worked as a marble installer. He had other relevant medical history. He came to the clinic after 7 days of progressive edema of the lower limbs, which progressed to anasarca, fatigue, weakness and oliguria. Review of systems: Negative. His blood pressure was 160/100<span class="elsevierStyleHsp" style=""></span>mmHg and he was pale; the rest of the examination provided no relevant data. The patient developed nephritic and nephrotic syndromes. The results of paraclinical studies on admission are seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The hepatic function tests, antinuclear antibodies, antibodies against core extractable antigens, anti-DNA, complement levels, antistreptolysin, hepatitis B and C, ELISA for human immunodeficiency virus and syphilis serology were negative. ANCA were positive at 1:160, with a perinuclear pattern by indirect immunofluorescence and positive myeloperoxidase antibodies by ELISA (normal values 0–20, 133 international units). We also ruled out Goodpasture syndrome (negative glomerular basement membrane antibodies) and other ANCA-associated vasculitis by clinical features and negative specific autoantibodies.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Renal biopsy revealed glomerulonephritis with global and segmental sclerosis and a collapsing aspect, glomerular hypoperfusion, podocyte hypertrophy, interstitial fibrosis and tubular atrophy of over 70%, with evidence of fibrinoid necrosis and karyorrhexis, with extracapillary proliferation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Cyclophosphamide 200<span class="elsevierStyleHsp" style=""></span>mg intravenously (IV) and methylprednisolone 500<span class="elsevierStyleHsp" style=""></span>mg IV daily for 3 days and then prednisolone 1<span class="elsevierStyleHsp" style=""></span>mg/kg/day in divided doses were started, and renal replacement therapy (intermittent hemodialysis) was indicated. The total time of hospitalization was 10 days.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient was readmitted 3 weeks later due to malaise, fever and hemoptysis. A chest X-ray showed evidence of reticular and diffuse alveolar interstitial infiltrates. A lung biopsy showed nodular silicosis. A new dose of cyclophosphamide and methylprednisolone, same as the above, was administered, with improvement of respiratory symptoms. No significant changes occurred with respect to the values of azotemia, urinary sediment or 24<span class="elsevierStyleHsp" style=""></span>h proteinuria.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Two weeks later, the patient was readmitted for dyspnea and tachypnea. He presented hypoxemia (oxygen saturation 85%), hemoptysis, and drop in hemoglobin from baseline (8–6<span class="elsevierStyleHsp" style=""></span>g/L); no clinical focus of bleeding or biochemical evidence of hemolysis was identified. There was a rapid progression to hypoxemic respiratory failure requiring ventilatory support. Bronchoalveolar lavage with the presence of 45% hemosiderophages without infection was practiced. Carbon monoxide diffusion was 125% (normal up to 90%). Three sessions of plasmapheresis were performed, but the patient was hemodynamically unstable, with high ventilatory requirements, and died.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The initial organ affected with silica exposure was the lung (silicosis). Necrosis and apoptosis of alveolar macrophages, production of proinflammatory cytokines (tumor necrosis factor, interleukin-1), increased cytotoxic T cell survival, decreased regulatory cells and enhanced reactive oxygen species are phenomena generated. In general, the patient had few symptoms; dyspnea should prompt a complication or another associated entity.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">This has also been linked with the production of ANCA; they may be directed against various antigens (proteinase 3, myeloperoxidase, lactoferrin and bactericidal permeability increasing protein).<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> To the best of our knowledge, reported cases of vasculitis secondary to silica are controversial.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Bartůnková et al. analyzed 86 individuals exposed to silica for at least 5 years; presence of ANCA was more frequent in those exposed (17.1%) than in controls (3.6%). The <span class="elsevierStyleItalic">odds ratio</span> (OR) was 5.04 (95% CI, 1.2–21.2).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The case being reported is similar to those described in the literature: Tervaert et al. explored the relationship between silica and the development of systemic vasculitis, finding an OR for renal failure after rapidly progressive glomerulonephritis of 2.5 (95% CI, 1.37–4.60) and 6.5 for pulmonary vasculitis (95% CI, 1.4–11.6).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Hogan et al., in a case–control study, found an increased risk of small-vessel vasculitis associated with ANCA after high exposure to silica (5 years) (OR 1.9, 95%, 1–3.5, <span class="elsevierStyleItalic">P</span>=.05).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The pathophysiology is similar to that of silicosis, but the target cell is a neutrophil.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="par0055" class="elsevierStylePara elsevierViewall">This case illustrates the probable association between severe microscopic polyangiitis and prolonged exposure to silica. Given the limited number of reported cases of this association, the prevalence of silicosis among those exposed and the frequency of development of autoimmune diseases remain unknown.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical Responsibilities</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of people and animals</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no experiments have been performed on humans or animals.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Data confidentiality</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their workplace regarding the publication of data from patients and that all patients included in the study have received sufficient information and have given their written informed consent to participate in the study.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors state that no patient data appears in this article.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of Interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres346838" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec328500" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres346839" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec328501" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical Observation" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusion" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical Responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of Interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-01-24" "fechaAceptado" => "2013-04-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec328500" "palabras" => array:5 [ 0 => "Silicosis" 1 => "Microscopic polyangiitis" 2 => "Antineutrophil cytoplasmic antibodies" 3 => "Rapidly progressive glomerulonephritis with pulmonary hemorrhage" 4 => "Autoimmunity" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec328501" "palabras" => array:5 [ 0 => "Silicosis" 1 => "Poliangiítis microscópica" 2 => "Anticuerpos anticitoplasma del neutrófilo" 3 => "Glomerulonefritis rápidamente progresiva con hemorragia pulmonar" 4 => "Autoinmunidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">There is sufficient evidence of the capacity of silica to induce autoimmunity in patients with some type of genetic susceptibility. There are several autoimmune diseases related to this exposure (rheumatoid arthritis, Sjögren's syndrome, sarcoidosis, and systemic sclerosis). Nodular silicosis (clinical expression of this exposure in lungs) generates apoptosis, inflammation, loss of tolerance and a respiratory burst. There is evidence that relates silica with induction of antineutrophil cytoplasmic antibodies, but, until it is better explained, the reports of systemic vasculitis secondary to silica exposure are inconclusive. We describe the case of a patient with a history of occupational exposure to silica who developed microscopic polyangiitis.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Existe suficiente evidencia de la capacidad de la sílice de inducir autoinmunidad en pacientes con algún tipo de susceptibilidad genética. Existen varias enfermedades autoinmunes relacionadas con esta exposición (artritis reumatoide, síndrome de Sjögren, sarcoidosis, esclerosis sistémica). La silicosis nodular (expresión clínica pulmonar de esta exposición) genera fenómenos de apoptosis, inflamación, pérdida de la tolerancia y explosión respiratoria. También se ha descrito la inducción de anticuerpos anticitoplasma del neutrófilo con este mineral, pero hay reportes no concluyentes de vasculitis sistémicas secundarias a la exposición a la sílice. Se describe el caso de un paciente con antecedente de exposición ocupacional a sílice que desarrolla una poliangiítis microscópica.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vega Miranda J, Pinto Peñaranda LF, Márquez Hernández JD, Velásquez Franco CJ. Poliangiítis microscópica secundaria a exposición a sílice. Reumatol Clin. 2014;10:180–182.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 676 "Ancho" => 900 "Tamanyo" => 143356 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Renal biopsy evidence of glomerulonephritis with segmental necrotizing extracapillary proliferation (long arrow) with marked interstitial fibrosis and tubular atrophy (short arrow).</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Result \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Normal value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine (mg/%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8–1.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urea nitrogen (mg/%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.2–10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urinalysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 erythrocytes/AP; 500<span class="elsevierStyleHsp" style=""></span>mg protein, erythrocyte and leukocyte cylinders (5–10/AP) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Protein in 24-h urine (mg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Less than 120 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hemoglobin (g/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12–16 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab517349.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Initial Paraclinical Data.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicosis. Brief review and experience of a pulmonology ward" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Santos" 1 => "A. Norte" 2 => "F. Fradinho" 3 => "A. Catarino" 4 => "A.J. Ferreira" 5 => "M. Loureiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Port Pneumol" "fecha" => "2010" "volumen" => "16" "paginaInicial" => "99" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20054511" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silica apoptosis, and autoimmunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Brown" 1 => "J.C. Pfau" 2 => "M.A. Pershouse" 3 => "A. Holian" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/15476910490911922" "Revista" => array:6 [ "tituloSerie" => "J Immunotoxicol" "fecha" => "2005" "volumen" => "1" "paginaInicial" => "177" "paginaFinal" => "187" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18958651" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic and pathogenetic role of antineutrophil cytoplasmic autoantibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Bartůnková" 1 => "V. Tesar" 2 => "A. Sedivá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Immunol" "fecha" => "2003" "volumen" => "106" "paginaInicial" => "73" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12672398" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silica exposure and systemic vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.B. Mulloy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Environ Health Perspect" "fecha" => "2003" "volumen" => "111" "paginaInicial" => "1933" "paginaFinal" => "1938" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14644669" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silica and asbestos exposure in ANCA-associated vasculitis with pulmonary involvement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Rihova" 1 => "D. Maixnerova" 2 => "E. Jancova" 3 => "D. Pelclova" 4 => "J. Bartunkova" 5 => "Z. Fenclova" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ren Fail" "fecha" => "2005" "volumen" => "27" "paginaInicial" => "605" "paginaFinal" => "608" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16153001" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microscopic polyangiitis accompanied by pleuritis as the only pulmonary manifestation of occupational silica exposure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Shibuya" 1 => "H. Sano" 2 => "K. Osamura" 3 => "K. Kujime" 4 => "K. Hara" 5 => "T. Hisada" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Intern Med" "fecha" => "2010" "volumen" => "49" "paginaInicial" => "925" "paginaFinal" => "929" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20467178" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silica exposure in anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis and lupus nephritis" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Glomerular Disease Collaborative Network" "etal" => false "autores" => array:6 [ 0 => "S.L. Hogan" 1 => "K.K. Satterly" 2 => "M.A. Dooley" 3 => "P.H. Nachman" 4 => "J.C. Jennette" 5 => "R.J. Falk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2001" "volumen" => "12" "paginaInicial" => "134" "paginaFinal" => "142" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11134259" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exposure to silica and risk of ANCA-associated vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Bartůnková" 1 => "D. Pelclová" 2 => "Z. Fenclová" 3 => "A. Sedivá" 4 => "J. Lebedová" 5 => "V. Tesar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajim.20327" "Revista" => array:6 [ "tituloSerie" => "Am J Ind Med" "fecha" => "2006" "volumen" => "49" "paginaInicial" => "569" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16691610" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicon exposure and vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.W. Tervaert" 1 => "C.A. Stegeman" 2 => "C.G. Kallenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Opin Rheumatol" "fecha" => "1998" "volumen" => "10" "paginaInicial" => "12" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9448985" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of silica exposure with anti-neutrophil cytoplasmic autoantibody small-vessel vasculitis: a population-based, case–control study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.L. Hogan" 1 => "G.S. Cooper" 2 => "D.A. Savitz" 3 => "L.A. Nylander-French" 4 => "C.G. Parks" 5 => "H. Chin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.03501006" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol" "fecha" => "2007" "volumen" => "2" "paginaInicial" => "290" "paginaFinal" => "299" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17699427" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001000000003/v2_201406190029/S2173574313001330/v2_201406190029/en/main.assets" "Apartado" => array:4 [ "identificador" => "17376" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Case Report" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001000000003/v2_201406190029/S2173574313001330/v2_201406190029/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313001330?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 4 | 11 |
| 2024 October | 47 | 28 | 75 |
| 2024 September | 55 | 19 | 74 |
| 2024 August | 66 | 27 | 93 |
| 2024 July | 44 | 44 | 88 |
| 2024 June | 71 | 38 | 109 |
| 2024 May | 67 | 38 | 105 |
| 2024 April | 91 | 26 | 117 |
| 2024 March | 69 | 28 | 97 |
| 2024 February | 34 | 28 | 62 |
| 2024 January | 44 | 24 | 68 |
| 2023 December | 39 | 24 | 63 |
| 2023 November | 52 | 41 | 93 |
| 2023 October | 50 | 36 | 86 |
| 2023 September | 77 | 32 | 109 |
| 2023 August | 53 | 22 | 75 |
| 2023 July | 48 | 28 | 76 |
| 2023 June | 42 | 27 | 69 |
| 2023 May | 59 | 33 | 92 |
| 2023 April | 37 | 9 | 46 |
| 2023 March | 68 | 26 | 94 |
| 2023 February | 60 | 24 | 84 |
| 2023 January | 31 | 35 | 66 |
| 2022 December | 56 | 30 | 86 |
| 2022 November | 60 | 35 | 95 |
| 2022 October | 67 | 38 | 105 |
| 2022 September | 47 | 31 | 78 |
| 2022 August | 46 | 44 | 90 |
| 2022 July | 36 | 40 | 76 |
| 2022 June | 45 | 37 | 82 |
| 2022 May | 47 | 45 | 92 |
| 2022 April | 44 | 44 | 88 |
| 2022 March | 55 | 38 | 93 |
| 2022 February | 63 | 30 | 93 |
| 2022 January | 66 | 40 | 106 |
| 2021 December | 44 | 37 | 81 |
| 2021 November | 41 | 45 | 86 |
| 2021 October | 57 | 53 | 110 |
| 2021 September | 68 | 37 | 105 |
| 2021 August | 57 | 33 | 90 |
| 2021 July | 52 | 30 | 82 |
| 2021 June | 47 | 46 | 93 |
| 2021 May | 66 | 37 | 103 |
| 2021 April | 145 | 59 | 204 |
| 2021 March | 63 | 44 | 107 |
| 2021 February | 57 | 22 | 79 |
| 2021 January | 45 | 22 | 67 |
| 2020 December | 29 | 25 | 54 |
| 2020 November | 37 | 10 | 47 |
| 2020 October | 36 | 15 | 51 |
| 2020 September | 54 | 33 | 87 |
| 2020 August | 29 | 25 | 54 |
| 2020 July | 35 | 23 | 58 |
| 2020 June | 27 | 35 | 62 |
| 2020 May | 39 | 9 | 48 |
| 2020 April | 29 | 12 | 41 |
| 2020 March | 16 | 7 | 23 |
| 2020 February | 1 | 0 | 1 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 58 | 21 | 79 |
| 2018 March | 83 | 16 | 99 |
| 2018 February | 40 | 13 | 53 |
| 2018 January | 61 | 7 | 68 |
| 2017 December | 34 | 10 | 44 |
| 2017 November | 49 | 14 | 63 |
| 2017 October | 29 | 9 | 38 |
| 2017 September | 23 | 10 | 33 |
| 2017 August | 40 | 23 | 63 |
| 2017 July | 25 | 22 | 47 |
| 2017 June | 49 | 12 | 61 |
| 2017 May | 54 | 17 | 71 |
| 2017 April | 45 | 13 | 58 |
| 2017 March | 47 | 32 | 79 |
| 2017 February | 26 | 21 | 47 |
| 2017 January | 32 | 19 | 51 |
| 2016 December | 68 | 19 | 87 |
| 2016 November | 60 | 14 | 74 |
| 2016 October | 80 | 15 | 95 |
| 2016 September | 64 | 8 | 72 |
| 2016 August | 92 | 9 | 101 |
| 2016 July | 29 | 8 | 37 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 1 | 0 | 1 |
| 2015 July | 18 | 6 | 24 |
| 2015 June | 35 | 9 | 44 |
| 2015 May | 69 | 17 | 86 |
| 2015 April | 77 | 15 | 92 |
| 2015 March | 51 | 8 | 59 |
| 2015 February | 55 | 7 | 62 |
| 2015 January | 68 | 19 | 87 |
| 2014 December | 47 | 15 | 62 |
| 2014 November | 40 | 11 | 51 |
| 2014 October | 42 | 13 | 55 |
| 2014 September | 41 | 18 | 59 |
| 2014 August | 36 | 14 | 50 |
| 2014 July | 33 | 18 | 51 |
| 2014 June | 76 | 44 | 120 |
| 2014 May | 40 | 15 | 55 |
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