トルエンジイソシアネートの長期暴落による慢性過敏性肺臓炎の1例  [in Japanese] A Case of Chronic Hypersensitivity Pneumonitis Due to Long Term Exposure to Toluene Diisocyanate  [in Japanese]

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Author(s)

    • 藤本 尚 FUJIMOTO Hisashi
    • 和歌山県立医科大学付属紀北分院内科 Department of Internal Medicine, Wakayama Medical College Kihoku Hospital
    • 上谷 光作 UETANI Kousaku
    • 和歌山県立医科大学付属紀北分院内科 Department of Internal Medicine, Wakayama Medical College Kihoku Hospital
    • 駿田 直俊 SUMDA Tadatoshi
    • 和歌山県立医科大学付属紀北分院内科 Department of Internal Medicine, Wakayama Medical College Kihoku Hospital
    • 船迫 真人 FUNASAKO Masato
    • 和歌山県立医科大学付属紀北分院内科 Department of Internal Medicine, Wakayama Medical College Kihoku Hospital
    • 大畑 雅洋 OHATA Masahiro
    • 和歌山県立医科大学付属紀北分院内科 Department of Internal Medicine, Wakayama Medical College Kihoku Hospital

Abstract

55歳男性. 20歳より35年間自動車整備業に従事し, トルエンジイソシアネートを含有する塗装剤を使用してきた. 51歳の時呼吸器症状が出現. 胸部で血 fine crackle を聴取し, ばち指を認める. 胸部CTにて不規則な分布の網状輪状影を呈し, 開胸肺生検では, Masson 体, 肉芽腫は認めなかったものの, リンパ球の浸潤を主体とした胞隔炎と線維化, 蜂窩肺を認め, 間質性肺炎の病像を呈していた. 組織所見からは典型的な特発性間質性肺炎とは考えにくく, 膠原病やサルコイドーシスも否定的で, トルエンジイソシアネート特異的抗体が強陽性であることなどから, 本物質の長期暴露による慢性過敏性肺臓炎と診断した. イソシアネートを原因とする過敏性肺臓炎の本邦報告例はすべて急性で, 本症例のように蜂窩肺にまで至った慢性例は見当たらない. 非常にまれな症例と考え, 報告する.

A 55-year-old paint sprayer, who had been working with paint containing toluence diisocyanate since age 20, was admitted to our hospital with a complaint of exertional dyspnea. Physical examination revealed clubbed fingers, and fine crackles were audible in both lower lung fields. The thoracic CT film showed diffuse linear and ringed shadows in both lung fields. Open lung biopsy disclosed alveolitis and fibrosis as well as infiltration of mononuclear cells, but no Masson bodies or granulomas. Toluene diisocyanate-specific antibody was positive. Based on these results, we diagnosed chronic hypersensitivity pneumonitis due to the chemical.<br>To our knowledge, there has been no previously reported case of chronic hypersensitivity pneumonitis due to isocyanate.`

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 33(4), 429-432, 1995-04-25

    The Japanese Respiratory Society

References:  11

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008106996
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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