PT  - JOURNAL ARTICLE
AU  - R. Merget
AU  - B. Marczynski
AU  - Z. Chen
AU  - K. Remberger
AU  - M. Raulf-Heimsoth
AU  - P.O. Willroth
AU  - X. Baur
TI  - Haemorrhagic hypersensitivity pneumonitis due to naphthylene-1,5-diisocyanate
AID  - 10.1183/09031936.02.00244702
DP  - 2002 Feb 01
TA  - European Respiratory Journal
PG  - 377--380
VI  - 19
IP  - 2
4099  - http://erj.ersjournals.com/content/19/2/377.short
4100  - http://erj.ersjournals.com/content/19/2/377.full
SO  - Eur Respir J2002 Feb 01; 19
AB  - Symptoms of hypersensitivity pneumonitis and massive pulmonary haemorrhage occurred in a 24-yr-old male shortly after occupational exposure to naphthylene-1,5-diisocyanate (NDI). The present examination was performed ∼1-yr after the initial life-threatening haemoptysis and following an uneventful recovery after resection of the middle lobe, which had been identified bronchoscopically as the bleeding source. Histological re-examination of the lung was compatible with hypersensitivity pneumonitis. After a chamber challenge with NDI (5 parts per billion (ppb) for 10 min, 10 ppb for 110 min), rales were heard in both lungs, and a fall in vital capacity and partial pressure of arterial oxygen as well as a rise in body temperature were documented. Isocyanate-specific immunoglobulin-G antibodies could not be detected in the patient's serum, possibly due to the long period without exposure to isocyanates. The authors conclude that naphthylene-1,5-diisocyanate may cause immunological pulmonary haemorrhage. The underlying disease is consistent with hypersensitivity pneumonitis and may be triggered by low concentrations of the diisocyanate.