Unusual hard metal lung disease: bronchiolocentric interstitial pneumonia.
Jen-Yu HsuF-Y ChuP-H WangM-L WuPublished in: Occupational medicine (Oxford, England) (2024)
A 38-year-old woman experienced a persistent dry cough and progressively worsening dyspnoea for 2 years. Spirometry testing revealed a moderate-to-severe restrictive abnormality. High-resolution chest computed tomography showed diffuse reticulonodular opacities. A lung biopsy disclosed alveolar parenchymal inflammation and fibrosis with bronchiolocentric features, prompting consideration of interstitial pneumonia. Following a thorough investigation of her occupational history and an on-site inspection, it was discovered that the patient had been grinding drill bits designed for printed circuit boards for 8 years, exposing her to hard metals. Mineralogical analyses confirmed excessive tungsten in urine, serum and hair, leading to a diagnosis of hard metal lung disease due to tungsten carbide-cobalt exposure. After discontinuing exposure and commencing corticosteroid therapy, her symptoms, pulmonary function and imaging showed modest improvement. This case highlights the significance of assessing occupational history in patients with interstitial pneumonia and understanding industrial hazards for accurate diagnosis and care.
Keyphrases
- high resolution
- computed tomography
- healthcare
- oxidative stress
- respiratory failure
- palliative care
- community acquired pneumonia
- magnetic resonance imaging
- case report
- positron emission tomography
- heavy metals
- magnetic resonance
- single cell
- high intensity
- quality improvement
- wastewater treatment
- contrast enhanced
- photodynamic therapy
- sleep quality
- extracorporeal membrane oxygenation
- tandem mass spectrometry
- chronic pain
- pain management
- fluorescence imaging
- mechanical ventilation
- pet ct
- health insurance
- replacement therapy