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ARTICLE TYPE : SYSTEMATIC REVIEW

Published on :   05 Sep 2026, Volume - 2
Journal Title :   WebLog Journal of Pulmonology and Respiratory Medicine | WebLog J Pulmonol Respir Res | WJPRM
Journal ISSN:   3142-9335
Source URL:   weblog icon https://weblogoa.com/articles/wjprm.2026.i0501
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.22646694

Pulmonary Talcosis Across Five Decades: A Route-Based Systematic Review of 40 Patient-Level Cases

Biplab Adhikari 1 *
Prekshya Parajuli 2
Alina Dhital 3
Rita Bhandari 4
Bipin Adhikari 5
1Internal Medicine, Wellstar Spalding Medical Center, Griffin, Georgia, USA
2Family Medicine, Southern New Mexico Family Medicine Residency Program, Las Cruces, New Mexico, USA
3Internal Medicine, Southern Regional Medical Center, Riverdale, Georgia, USA
4Infectious Disease, University of Louisville, Louisville, Kentucky, USA
5Internal Medicine, Kingman Regional Medical Center, Kingman, Arizona, USA

Abstract

Objective: To synthesize patient-level evidence on pulmonary talcosis and compare demographic, exposure-related, clinical, radiologic, histopathologic, management, and outcome patterns across exposure routes.

Methods: PubMed, Google Scholar, and ScienceDirect were searched from inception through April 2026 for patient-level reports. PRISMA 2020, PRISMA-S, and SWiM guidance were followed. Data were summarized descriptively, and selected route comparisons used Fisher exact tests and odds ratios with 95% confidence intervals.

Results: Thirty-five articles describing 40 patients were included. Mean age was 43.8±15.2 years, and 25 patients (62.5%) were male. Intravenous drug or excipient exposure was most common (21/40, 52.5%), followed by occupational or industrial inhalation (8/40, 20.0%), cosmetic talc inhalation (7/40, 17.5%), cocaine or recreational inhalation (3/40, 7.5%), and mixed exposure (1/40, 2.5%). Dyspnea occurred in 28 patients (70.0%), cough in 20 (50.0%), and hypoxemia or respiratory failure in 9 (22.5%). Foreign-body granulomas and birefringent particles were reported in 30 (75.0%) and 29 (72.5%), respectively. Fibrosis was more frequent in occupational than nonoccupational cases (75.0% vs. 31.3%; p=0.042). Ten deaths (25.0%) were reported, but publication bias and incomplete follow-up precluded mortality estimation.

Conclusions: Pulmonary talcosis demonstrates route-specific clinicopathologic patterns. Diagnosis depends on a detailed exposure history and, when needed, tissue examination with polarized light microscopy. Management is primarily exposure cessation and supportive care; evidence supporting disease-specific treatment remains insufficient.

Keywords: Talc; Lung Diseases, Interstitial; Pneumoconiosis; Granuloma, Foreign-Body; Substance Abuse, Intravenous; Occupational Exposure

Citation

Adhikari B, Parajuli P, Dhital A, Bhandari R, Adhikari B. Pulmonary Talcosis Across Five Decades: A Route Based Systematic Review of 40 Patient Level Cases. WebLog J Pulmonol Respir Res. wjprm.2026.i0501 https://doi.org/10.5281/zenodo.22646694