Reactive airways dysfunction syndrome following metal fume fever.
Metal fume fever (MFF) is an acute response to the inhalation of heavy metals used in industry. The patient typically experiences symptoms of cough, fever, chills, malaise, and myalgia that are self-limited and of short duration. Wheezing may occur and pulmonary function may be acutely impaired with a decrease in lung volumes and diffusing capacity of carbon monoxide. Nevertheless, respiratory function quickly returns to normal, and persistent pulmonary insufficiency is unusual. Irritant-induced asthma is a non-immunogenic form of airway injury that may be associated with industrial inhalation exposure. In this situation, the direct toxic effect on the airways causes persistent airway inflammation and bronchial hyperreactivity. The two conditions are considered distinct entities, but we report a previously healthy worker who had classic MFF and was left with irritant-induced asthma or reactive airways dysfunction syndrome (RADS).
Dube
Daniel
D
Quillen Veterans Affairs Medical Center, Division of Pulmonary Medicine and Critical Care, 111-B, PO Box 4000, Mountain Home, TN 37684-4000, USA.
Puruckherr
Michael
M
Byrd
Ryland P
RP
Roy
Thomas M
TM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016535:Bronchial Hyperreactivity; D006801:Humans; D007509:Irritants / Q000009:adverse effects*; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010102:Oxygen Inhalation Therapy; D010316:Particle Size; D012129:Respiratory Function Tests; D013577:Syndrome; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D007509:Irritants; D008670:Metals