RT Journal Article
SR Electronic
T1 Haemorrhagic hypersensitivity pneumonitis due to naphthylene-1,5-diisocyanate
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 377
OP 380
DO 10.1183/09031936.02.00244702
VO 19
IS 2
A1 R. Merget
A1 B. Marczynski
A1 Z. Chen
A1 K. Remberger
A1 M. Raulf-Heimsoth
A1 P.O. Willroth
A1 X. Baur
YR 2002
UL http://erj.ersjournals.com/content/19/2/377.abstract
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.