title: Hypersensitivity pneumonitis and exposure to zirconium silicate in a young ceramic tile worker.
abstract: We describe a nonsmoking ceramic tile worker 25 yr of age who developed a worsening dry cough and dyspnea after 3.5 yr as a sorter and glazer of tiles. Open lung biopsy revealed an intense granulomatous interstitial pneumonia with mild fibrosis, compatible with hypersensitivity pneumonitis, and numerous very small birefringent crystals around the terminal airways and occasionally in granulomas. Pulmonary particle analysis revealed an inhaled dust burden nearly 100-fold the normal background level, mainly consisting of clay minerals and zirconium silicate. The patient had no history or clinical or laboratory findings suggesting any organic etiologic agent. A sarcoid granulomatosis type of chronic pulmonary hypersensitivity reaction is known after long-term exposure to zirconium, but this case demonstrates that zirconium can also cause an acute and fulminant allergic alveolitislike hypersensitivity reaction.
authors.affiliation: Department of Diseases of the Chest, Turku University Central Hospital, Finland.
authors.forename: K K
authors.initials: KK
authors.lastname: Liippo
authors.forename: S L
authors.initials: SL
authors.lastname: Anttila
authors.forename: O
authors.initials: O
authors.lastname: Taikina-Aho
authors.forename: E L
authors.initials: EL
authors.lastname: Ruokonen
authors.forename: S T
authors.initials: ST
authors.lastname: Toivonen
authors.forename: T
authors.initials: T
authors.lastname: Tuomi
mesh_terms: D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D001706:Biopsy; D002516:Ceramics; D002908:Chronic Disease; D004391:Dust / Q000032:analysis; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D011859:Radiography; D017640:Silicates / Q000009:adverse effects* / Q000032:analysis; D015040:Zirconium / Q000009:adverse effects* / Q000032:analysis
chemical_list: D004391:Dust; D017640:Silicates; C003784:zircon; D015040:Zirconium