Asia Pacific Journal of Medical Toxicology

Systemic Lupus Erythematosus and Occupational Exposure to Solvents: A Case Report

Document Type : Case Report

Authors

Angelica Dos Santos Vianna 1
Isabela Carmona Castro Rodriguez 2
Leandro Machado de Matos 2
aline souza espindola santos 3

1 Instituto de Estudos em Saúde Coletiva / Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho / Universidade Federal do Rio de Janeiro

2 Faculty of Medicine, Rio de Janeiro Federal University, Rio de Janeiro, Brazil

3 Collective Health Studies Institute, Rio de Janeiro Health Institute, Rio de Janeiro, Brazil

https://doi.org/10.22038/apjmt.2023.21877
Abstract
Introduction: Systemic Lupus Erythematosus (SLE) cases have been growing over the years, and the role of environmental agents are at the center of investigations. However, few studies have addressed the role of solvents. Therefore, we reported an SLE case in a patient with long-term low-level exposure to organic solvents in the workplace.
Case Report: A 58-year-old black female attended a teaching hospital evaluation due to oral ulcers, 14 kilos loss, and leukopenia. Her occupational history revealed a 24-year exposure to organic solvents with inadequate protection. After investigation, we made an SLE diagnosis related to solvents based on clinical presentation and laboratory tests (anemia, leukopenia, hypocomplementemia, positive antinuclear antibodies, and biomarkers of exposure). The patient’s treatment included corticosteroids, immunosuppressive, and antimalarial drugs. As a result, she gradually improved in clinical and laboratory conditions.
Discussion: We addressed the potential role of solvents in developing SLE in this case report regarding a patient chronically exposed to them. SLE is a multifactorial disease triggered in genetically-prone individuals by environmental exposure. Although few studies have addressed the relationship between solvents and SLE with mixed results, strong evidence links them with other autoimmune diseases. There is biological plausibility for solvents triggering SLE, as autoimmune diseases share clinical presentation, genetic factors, and physiopathologic mechanisms. 
Conclusion: Our case highlights the potential role of solvents in developing SLE. Although there are mixed results on this relationship, strong evidence associates them with other autoimmune diseases. Considering the wide use of solvents in many contexts and the similarity between autoimmune diseases, we recommend further investigations.

Keywords

Lupus Erythematosus, Systemic
Occupational Exposure
Solvents
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Asia Pacific Journal of Medical Toxicology
Volume 11, Issue 4 - Serial Number 4
Autumn 2022
Pages 172-176

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