The clinical picture. In addition to the production of dust, the clinical picture is largely determined by the degree of developing lung fibrosis, its form (mainly nodular or interstitial) and the presence of concomitant diseases. Clinical symptoms of pneumoconiosis often until expressed stages is scarce. The most typical complaints of patients - unstable tingling chest pain, often in the blades, due to changes of the pleura; shortness of breath, in the initial stages of the disease appear only at large physical stress, as the progression conticello process is observed even at rest; cough mostly dry. Percussion, mainly in the top-side departments of the chest, due to emphysema is a box shade, breathing becomes harsh, can listen dry or moist rales. Already in the early stages of the disease often appear violations of respiratory function, generally increasing with the progression of the process. In more severe stages joins heart failure and may develop pulmonary heart.

Fig. 5. Berillios. Granulomas with conchoidal cells in the lungs (x 400).

Pneumoconiosis is not isolated pulmonary disease. When silicosis often observed hypertrophic and atrophic changes of the mucous membrane of the upper respiratory tract, disturbed secretory and sometimes motor function of the stomach, pancreas, increasing the content of histamine in the lungs, decreases the rate of splitting carbohydrates, are inhibited oxidation processes, changes the metabolism of amino acids, the balance of vitamins, the ratio of protein fractions of blood, accelerated ROHE. These changes are not decisive diagnostic signs, but can be used based on the data of x-ray studies of the lungs. Complications of pneumoconiosis can be a tuberculosis of lungs, chronic bronchitis, sometimes taking the form of asthma, bronchiectasis, heart failure (by type pulmonary heart); spontaneous pneumothorax, pneumonia, conditionsa the cavern. Especially adversely flows combination of pneumoconiosis with tuberculosis (geniotubercle), this complication is more likely to occur when silicosis. Other types P., such as asbestosis and antracot, often complicated by chronic bronchitis.