Talcum induced pneumoconiosis following inhalation of adulterated marijuana, a case report
- Equal contributors
1 Institute of Pathology, Klinikum Bremen-Mitte, St.-Jürgen-Str. 1, 28177 Bremen, Germany
2 Department of Pneumology and Respiratory Medicine, Klinikum Bremen-Ost, Züricher Str. 40, 28325 Bremen, Germany
3 Institute of Pathology, Ruhr-Universität Bochum, Berufsgenossenschaftlichen Universitätsklinik Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
4 Department of Molecular Oncology, University Medicine Göttingen, Justus-von-Liebig-Weg 4, 37077 Göttingen, Germany
Diagnostic Pathology 2012, 7:26 doi:10.1186/1746-1596-7-26Published: 15 March 2012
Talcosis, a granulomatous inflammation of the lungs caused by inhalation of talcum dust, is a rare form of pneumoconiosis. Besides inhalative occupational exposure, intravenous abuse of adulterated drugs is a major cause for this condition. Minerals such as talcum (magnesium silicate) and sand (predominant silicon dioxide) are used to increase both volume and weight of illicit substances. In intravenous heroin-abuse, talcosis is a well-known complication. Here we describe a case of talcosis caused by inhalative abuse of adulterated marijuana.
A 29-year old man presented with persistent fever, dyspnea and cervical emphysema. He admitted consumption of 'cut' marijuana for several years, preferentially by water pipe smoking.
Lung-biopsies showed chronic interstitial lung disease, anthracotic pigments and birefringent material. Energy dispersive x-ray spectroscopy revealed silicon-containing particles (1-2 μm) and fine aluminum particles (< 1 μm), magnesium and several other elements forming a spectrum compatible with the stated water pipe smoking of talcum-adulterated marijuana.
The exacerbated chronic interstitial lung disease in a 29-year old patient could be attributed to his prolonged abuse of talcum-adulterated marjuana by histopathology and x-ray spectroscopy. Since cannabis consumption is widely spread among young adults, it seems to be justified to raise attention to this form of interstitial pulmonary disease.