Acute life-threatening extrinsic allergic alveolitis in a paint controller.

Détails

ID Serval
serval:BIB_BCF89B71BB6E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Acute life-threatening extrinsic allergic alveolitis in a paint controller.
Périodique
Occupational Medicine
Auteur(s)
Bieler Gilles, Thorn David, Huynh Cong Khanh, Tomicic Catherine, Steiner Urs Christian, Yawalkar Nikhil, Danuser Brigitta
ISSN
1471-8405 (Electronic)
ISSN-L
0962-7480
Statut éditorial
Publié
Date de publication
2011
Peer-reviewed
Oui
Volume
61
Numéro
6
Pages
440-442
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Occupational diisocyanate-induced extrinsic allergic alveolitis (EAA) is a rare and probably underestimated diagnosis. Two acute occupational EAA cases have been described in this context, but neither of them concerned hexamethylene diisocyanate (HDI) exposure. AIMS: To investigate the cause of a life-threatening EAA arising at work in a healthy 30-year-old female paint quality controller. METHODS: Occupational medical assessment, workplace evaluation, airborne and biological monitoring and immunodermatological tests. RESULTS: Diagnosis of EAA relied on congruent clinical and radiological information, confirmed occupational HDI exposure and positive IgG antibodies and patch tests. The patient worked in a small laboratory for 7 years, only occasionally using HDI-containing hardeners. While working with HDI for 6 h, she developed breathlessness, rapidly progressing to severe respiratory failure. Workplace HDI airborne exposure values ranged from undetectable levels to 4.25 p.p.b. Biological monitoring of urinary hexamethylene diamine in co-workers ranged from <1.0 to 15.4 μg/g creatinine. Patch tests 8 months later showed delayed skin reaction to HDI at 48 h. Subsequent skin biopsy showed spongiotic dermatitis with infiltration of CD4(+) and CD8(+) T cells. CONCLUSIONS: We believe this is the first reported case of acute life-threatening EAA following exposure to HDI. Low concentrations of airborne HDI and relatively high urinary hexamethylene diamine suggest significant skin absorption of HDI could have significantly contributed to the development of this acute occupational EAA.
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/08/2011 15:38
Dernière modification de la notice
09/05/2019 0:31
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