Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates☆,☆☆,★
Section snippets
METHODS
Sixteen patients were initially recruited from a group of 1780 isocyanate workers. Two hundred ninety-four workers from this group comprised the whole staff of four car and chemical factories. The remaining subjects were involved in medical surveillance programs for isocyanate workers or were patients of our outpatient department. All subjects underwent physical examination by a company physician who also recorded detailed case histories. Furthermore, chest x-ray films and lung function testing
Clinical investigations
Table I shows individual data on patients, occupational exposure to isocyanates, and symptoms. The subjects produced polyurethane foam, performed injection molding in foundries, sprayed paint, or worked in various other industrial branches. The preponderance of MDI exposure was noticeable (nine cases). Three paint sprayers had contact with an HDI biuret, and three handled TDI and other isocyanates. Workers' mean exposure period to isocyanates was 6.0 years (range, 0.5 to 20 years).
Each worker
DISCUSSION
Hypersensitivity pneumonitis is caused by the inhalation of different organic substances and mediated by cytotoxic mechanisms and various cellular and humoral immune responses. Although the individual pathogenetic role of these responses is not clear, it can be assumed that diagnostically used parameters such as specific IgG antibodies (which may lead to the formation of immune complexes and the activation of the complement cascade) and antigen-specific lymphocytic reactions are also operative
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2021, ChestCitation Excerpt :Biopsies can be classified as compatible with nonfibrotic HP pattern if the first three Major Features are identified but both granulomas and features of an alternative diagnosis are lacking (Figs 11A, 11B). Since this histologic picture can also be seen in other conditions including connective tissue disease,129,210 inhalational injuries,211 other environmental exposures,212,213 and drug toxicity,214,215 the more general term “compatible with” was chosen rather than “probable HP”. Because the histologic findings in these cases are relatively nonspecific, they do not necessarily imply that the diagnosis is probably HP.
Assessment and Management of Occupational Hypersensitivity Pneumonitis
2020, Journal of Allergy and Clinical Immunology: In PracticeCharacterization and comparative analysis of 2,4-toluene diisocyanate and 1,6-hexamethylene diisocyanate haptenated human serum albumin and hemoglobin
2016, Journal of Immunological MethodsCitation Excerpt :Both have high vapor pressures (Sullivan and Krieger, 2001) and exposure often occurs through inhalation of vapors and aerosols during spraying operations at workplaces. Immune-mediated hypersensitivity reactions to dNCOs include allergic rhinitis (Matheson et al., 2005), asthma (Mapp, 2001), hypersensitivity pneumonitis (Baur, 1995; Charles et al., 1976) and allergic contact dermatitis (Aalto-Korte et al., 2012). Although most reported cases of isocyanate sensitization occur at workplaces (Rudzinski et al., 1998; Redlich and Karol, 2002; Hur et al., 2008), it has been suggested that non-occupational exposure to the general public may also occur through the use of “do-it-yourself” free diisocyanate containing commercial products such as polyurethane foams and sprays (Krone, 2004; Wilder et al., 2011).
Hypersensitivity pneumonitis induced by isocyanates: About a new observation
2015, Archives des Maladies Professionnelles et de l'EnvironnementHypersensitivity Pneumonitis Due to Isocyanates: Lung Function, Clinical and Radiological Characteristics
2013, Archivos de Bronconeumologia
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From the Professional Associations' Research Institute for Occupational Medicine, Ruhr University.
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Reprint requests: Prof. X. Baur, Buerkle de la Comp-Pl. 1, D-44789 Bochum, Germany.
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