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Abstract
Case Report
A case of acute hypersensitivity pneumonitis and hard metal lung disease in a fitter turner caused by metalworking fluid
Kyoko Gochoa Hiroshige Shimizua Toshimasa Uekusab Hiroshi Moriyamac Kazutoshi Shibuyad Sakae Hommaa
aDepartment of Respiratory Medicine, Toho University Omori Medical Center
bDepartment of Pathology, Japan Labor Health and Welfare Organization Kanto Rosai Hospital
cDepartment of Respiratory Medicine, National Hospital Organization Nishi-Niigata Chuo National Hospital
dDepartment of Diagnostic Pathology, Toho University Omori Medical Center
ABSTRACT
A 74-year-old fitter turner was admitted for evaluation of abnormal shadowing on chest computed tomography, which showed fine nodular shadows in the upper lobes and subpleural fibrosis in the lower lobes. Bronchiolitis, alveolitis and non-caseating epithelioid cell granuloma in the left upper lobe, and a usual interstitial pneumonia (UIP) pattern of interstitial pneumonia in the left lower lobe were confirmed by surgical lung biopsy. We found that the patient had inhaled aerosolized metalworking fluids when fitting and turning and a workplace survey revealed that he used a tungsten-containing cutting knife. Gram negative bacillus was detected from cutting oil and tungsten was detected from trace element analysis of lung tissue. We diagnosed this case as hypersensitivity pneumonitis caused by metalworking fluids accompanied by hard metal lung disease.
KEYWORDS
Hypersensitivity pneumonitis Metalworking fluid Hard metal lung disease Tungsten
Received 19 Oct 2018 ／ Accepted 24 Jan 2019
AJRS, 8(3): 204-208, 2019
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