[A patient with Wegener's granulomatosis who worked in a foundry: a case for a causal association with silicon dioxide].

The diagnosis Wegener's granulomatosis was made in a 42-year-old man. Occupational history revealed prolonged exposure to large amounts of silicon dioxide in dust during work in a foundry. The illness was stabilized with immunosuppressive treatment, but after one year the patient developed aseptic necrosis in both hips, which ultimately led to essential total hip arthroplasty on the left side. The patient was unable to work since the diagnosis. Similar case reports have been described, as well as a limited number of case-control studies. These indicate an association between Wegener's granulomatosis and exposure to silicon. There is growing evidence for a causal role of silicon dioxide in the pathogenesis of auto-immune disease.