A Case of Occupational Hypersensitivity Pneumonitis Associated with Trichloroethylene

Trichloroethylene (TCE) is a toxic chemical commonly used as a degreasing agent, and it is usually found in a colorless or blue liquid form. TCE has a sweet, chloroform-like odor, and this volatile chlorinated organic chemical can cause toxic hepatitis, neurophysiological disorders, skin disorders, and hypersensitivity syndromes. However, the hypersensitivity pneumonitis (HP) attributed to TCE has rarely been reported. We hereby describe a case of HP associated with TCE in a 29-year-old man who was employed as a lead welder at a computer repair center. He was installing the capacitors on computer chip boards and had been wiped down with TCE. He was admitted to our hospital with complaints of dry coughs, night sweats, and weight losses for the past two months. HP due to TCE exposure was being suspected due to his occupational history, and the results of a video-associated thoracoscopic biopsy confirmed the suspicions. Symptoms have resolved after the steroid pulse therapy and his occupational change. TCE should be taken into consideration as a potential trigger of HP. Early recognition and avoidance of the TCE exposure in the future is important for the treatment of TCE induced HP.

keywords: Alveolitis, Extrinsic Allergic, Trichloroethylene, Occupational Exposure, Lung Diseases

Reference

1. Bakke B, Stewart PA, Waters MA. Uses of and exposure to trichloroethylene in U.S. industry: a systematic literature review. J Occup Environ Hyg 2007;4:375-90.

2. Tanios MA, El Gamal H, Rosenberg BJ, Hassoun PM. Can we still miss tetrachloroethylene-induced lung disease? The emperor returns in new clothes. Respiration 2004;71:642-5.

3. Hansen J, Sallmen M, Selden AI, Anttila A, Pukkala E, Andersson K, et al. Risk of cancer among workers exposed to trichloroethylene: analysis of three Nordic cohort studies. J Natl Cancer Inst 2013;105:869-77.

4. Parker JC, Bahlman LJ, Leidel NA, Stein HP, Thomas AW, Wolf BS, et al. Current NIOSH Intelligence Bulletin No. 20: tetrachloroethylene (perchloroethylene). Am Ind Hyg Assoc J 1978;39:A-23-A-29.

5. Pastino GM, Yap WY, Carroquino M. Human variability and susceptibility to trichloroethylene. Environ Health Perspect 2000;108 Suppl 2:201-14.

6. Kamijima M, Hisanaga N, Wang H, Nakajima T. Occupational trichloroethylene exposure as a cause of idiosyncratic generalized skin disorders and accompanying hepatitis similar to drug hypersensitivities. Int Arch Occup Environ Health 2007;80:357-70.

7. Goon AT, Lee LT, Tay YK, Yosipovitch G, Ng SK, Giam YC. A case of trichloroethylene hypersensitivity syndrome. Arch Dermatol 2001;137:274-6.

8. Schuyler M, Cormier Y. The diagnosis of hypersensitivity pneumonitis. Chest 1997;111:534-6.

9. Jacobs RL, Andrews CP, Coalson JJ. Hypersensitivity pneumonitis: beyond classic occupational disease-changing concepts of diagnosis and management. Ann Allergy Asthma Immunol 2005;95:115-28.

10.

10. Lacasse Y, Selman M, Costabel U, Dalphin JC, Ando M, Morell F, et al. Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med 2003;168:952-8.

11.

11. Tanaka H, Tsunematsu K, Nakamura N, Suzuki K, Tanaka N, Takeya I, et al. Successful treatment of hypersensitivity pneumonitis caused by Grifola frondosa (Maitake) mushroom using a HFA-BDP extra-fine aerosol. Intern Med 2004;43:737-40.

12.

12. Tong Z, Chen B, Dai H, Bauer PC, Guzman J, Costabel U. Extrinsic allergic alveolitis: inhibitory effects of pentoxifylline on cytokine production by alveolar macrophages. Ann Allergy Asthma Immunol 2004;92:234-9.

13.

13. Churg A, Muller NL, Flint J, Wright JL. Chronic hypersensitivity pneumonitis. Am J Surg Pathol 2006;30:201-8.

바로가기메뉴

Article Contents

Vol.76 No.2

A Case of Occupational Hypersensitivity Pneumonitis Associated with Trichloroethylene

Abstract

Reference

Tuberculosis & Respiratory Diseases