title: Combined asthma and alveolitis induced by cobalt in a diamond polisher.
abstract: A diamond polisher presented with a history of dyspnea, chest tightness, chills and weight loss related to exposure to diamond cobalt disks at work. Pulmonary function showed slightly reduced lung volumes, low normal diffusing capacity and a moderate bronchial hyperresponsiveness to histamine. Chest X-ray and cell count in bronchoalveolar lavage fluid were normal. After 3 months of non-exposure, a bronchial cobalt challenge test caused an immediate decrease in specific airway conductance and in vital capacity (VC) but not in FEV1/VC. After 6 h, chills, fever, tachycardia and crackles appeared along with moderate reductions in lung volumes. After 24 h, the bronchoalveolar lavage fluid showed 43% granulocytes, and there was a marked increase in bronchial hyperresponsiveness to histamine. These changes are interpreted as combined asthma and alveolitis induced by cobalt.
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology; D001249:Asthma / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D003035:Cobalt / Q000009:adverse effects*; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D011653:Pulmonary Diffusing Capacity
chemical_list: D003035:Cobalt