[Three cases of isocyanate-induced hypersensitivity pneumonitis with different HRCT findings]

Nihon Kokyuki Gakkai Zasshi. 2009 Sep;47(9):839-43.
[Article in Japanese]

Abstract

We reported 3 cases of hypersensitivity pneumonitis who had been exposed to polyurethane material containing diphenylmethane diisocyanate (MDI) for 1-12 weeks. They had cough, fever and dyspnea before admission. All 3 cases were diagnosed immunologically using anti-MDI antibodies. Chest HRCT findings of the 3 cases were different. Case 1 showed an organizing pneumonia (OP) pattern : patchy peripheral consolidation with air bronchogram and ground-glass opacities (GGO), and case 2 showed a nonspecific interstitial pneumonia (NSIP) pattern : consolidation and reticular shadows in both lower lobes. In addition, case 3 showed a hypersensitivity pneumonitis (HP) pattern : centrilobular GGO and diffuse granular shadows. All cases were successfully treated by corticosteroids alone. This suggests that different amounts of inhaled antigen can cause different HRCT findings.

Publication types

  • Case Reports

MeSH terms

  • Alveolitis, Extrinsic Allergic / chemically induced*
  • Alveolitis, Extrinsic Allergic / diagnostic imaging*
  • Alveolitis, Extrinsic Allergic / drug therapy
  • Humans
  • Isocyanates / adverse effects*
  • Isocyanates / immunology
  • Male
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / diagnostic imaging*
  • Occupational Exposure / adverse effects*
  • Pulse Therapy, Drug
  • Radiographic Image Enhancement*
  • Tomography, X-Ray Computed*
  • Treatment Outcome

Substances

  • Isocyanates
  • 4,4'-diphenylmethane diisocyanate
  • Methylprednisolone