title: Haemorrhagic hypersensitivity pneumonitis due to naphthylene-1,5-diisocyanate.
abstract: Symptoms of hypersensitivity pneumonitis and massive pulmonary haemorrhage occurred in a 24-yr-old male shortly after occupational exposure to naphthylene-1,5-diisocyanate (NDI). The present examination was performed approximately 1-yr after the initial life-threatening haemoptysis and following an uneventful recovery after resection of the middle lobe, which had been identified bronchoscopically as the bleeding source. Histological re-examination of the lung was compatible with hypersensitivity pneumonitis. After a chamber challenge with NDI (5 parts per billion (ppb) for 10 min, 10 ppb for 110 min), rales were heard in both lungs, and a fall in vital capacity and partial pressure of arterial oxygen as well as a rise in body temperature were documented. Isocyanate-specific immunoglobulin-G antibodies could not be detected in the patient's serum, possibly due to the long period without exposure to isocyanates. The authors conclude that naphthylene-1,5-diisocyanate may cause immunological pulmonary haemorrhage. The underlying disease is consistent with hypersensitivity pneumonitis and may be triggered by low concentrations of the diisocyanate.
authors.affiliation: Research Institute for Occupational Medicine, Bochum, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Merget
authors.forename: B
authors.initials: B
authors.lastname: Marczynski
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Remberger
authors.forename: M
authors.initials: M
authors.lastname: Raulf-Heimsoth
authors.forename: P O
authors.initials: PO
authors.lastname: Willrot
authors.forename: X
authors.initials: X
authors.lastname: Baur
mesh_terms: D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D017953:Isocyanates / Q000009:adverse effects*; D008168:Lung / Q000473:pathology; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced*
chemical_list: D017953:Isocyanates; C023446:1,5-naphthylene di-isocyanate