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  1. Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates.

    Article - En anglais

    Background 

    Chemical-induced hypersensitivity pneumonitis has been so far rarely described.

    The purpose of this study was to find out whether hypersensitivity pneumonitis is a common disorder in isocyanate workers.

    Methods 

    Company physicians'case histories of 1780 isocyanate workers were evaluated.

    In 16 subjects suspected of having isocyanate-induced hypersensitivity pneumonitis, chest x-ray films were made ; level of IgE and IgG antibodies to isocyanate-human serum albumin were estimated ; conjugates and isocyanate challenge tests, bronchoalveolar lavage fluid analyses, and/or lung histologic investigations were performed.

    Results 

    Each of the 14 study patients who had hypersensitivity pneumonitis had work-related dyspnea and fever occurring several hours after the start of work with isocyanates.

    Typical clinical findings were the reduction of lung diffusing capacity (n=10), reticular or nodular lung patterns in the r-ray film (n=9), and seem IgG antibodies specific to isocyanate-human serum albumin conjugates (n=10).

    Restrictive ventilation patterns in the inhalation challenge tests (n=5), lymphocytic and/or neutrophilic alveolitis seen in bronchoalveolar lavage fluid analyses (n=7), and lymphohistiocytic patterns mostly associated with mild fibrosis in lung histology (n=5) confirmed the diagnosis.

    Conclusions 

    Occupational exposure to isocyanate vapors and aerosols induces typical hypersensitivity pneumonitis in at least 1% of the isocyanate workers with symptoms.

    Mots-clés Pascal : Pneumopathie interstitielle, Toxicité, Composé chimique, Allergie, Isocyanate, Exposition professionnelle, Radiographie RX, IgG, Immunoglobuline, Anticorps, Lavage bronchoalvéolaire, Anatomopathologie, Exploration, Diagnostic, Homme, Appareil respiratoire pathologie, Poumon pathologie, Médecine travail, Immunopathologie, Radiodiagnostic

    Mots-clés Pascal anglais : Interstitial pneumonitis, Toxicity, Chemical compound, Allergy, Isocyanates, Occupational exposure, X ray radiography, IgG, Immunoglobulins, Antibody, Bronchoalveolar lavage, Pathology, Exploration, Diagnosis, Human, Respiratory disease, Lung disease, Occupational medicine, Immunopathology, Radiodiagnosis

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0343626

    Code Inist : 002B03L06. Création : 01/03/1996.