A 76-year-old man was referred to our hospital because of general malaise and labored breathing. He had worked as a construction worker and had been diagnosed with idiopathic thrombocytopenic purpura 2 years ago. No abnormalities were detected in his past chest X-ray images. Chest unenhanced computed tomography on admission showed bilateral plural effusion, minute granular shadows in the upper lobes, ground glass opacity, and mediastinal and hilar lymphadenopathy. In addition, the levels of PA IgG and anti-Jo-1 antibody were elevated. We performed transbronchial lung biopsy and subclavicular lymph node needle biopsy, but it did not lead to a diagnosis. The treatment was not effective and the patient died of hypercapnic respiratory failure. We performed left lung necropsy. Pathological findings revealed silicosis. Respiratory failure was subacute in this case, and the elevation of autoantibodies implied the involvement of an autoimmune-mechanism.