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Abstract

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Article in Japanese

Case Report

A Case of Pneumonitis Possibly Due to Isocyanate Associated with High Levels of Serum KL-6

Toshihiko Hashizume1)   Hiroyuki Numata1)  Kazuhiko Matsushita2)  

1)Department of Internal Medicine,2)Department of Pathology, Yokohama Sakae Kyousai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama, Japan

ABSTRACT

A 47-year-old automobile painter developed dry cough, chills and dyspnea after four months of painting work. The spray contained isocyanates (HDI). A chest radiograph showed bilateral ground-glass shadows. The serum KL-6 level was very high: 11,100U/ml. Marked lymphocytosis and a stiking decrease in the CD4/CD8 ratio were observed in the bronchoalveolar lavage fluid. Transbronchial lung biopsy specimens showed alveolitis and bronchiolitis. Cessation of exposure to isocyanates improved the symptoms and laboratory data. We suspected that the patient was suffering from hypersensitivity pneumonitis induced by isocyanates. Specific IgG antibodies for TDI, MDI, and HDI were not demonstrated by enzyme-linked immunosorbent assay. Because abnormal shadows in the chest radiograph did not improve quickly after admission, we administered glucocorticoids which improved the symptoms, the chest radiograph findings, and the serum KL-6 level.

KEYWORDS

Hypersensitivity pneumonitis  Isocyanate  KL-6  Nonspecific interstitial pneumonia  Interstitial pneumonia 

Received 平成12年10月10日

JJRS, 39(6): 442-445, 2001

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