title: Can we still miss tetrachloroethylene-induced lung disease? The emperor returns in new clothes.
abstract: Hypersensitivity pneumonitis (HP) is a complex syndrome of varying intensity and clinical presentation, and has been described in association with numerous exposures. Early diagnosis is essential to limit irreversible lung damage. We describe a case of HP in a 42-year-old dry cleaner following occupational exposure to tetrachloroethylene (TCE). The diagnosis was suspected based on clinical presentation and radiographic studies, and confirmed by lung biopsy. A review of the literature reveals that HP has not been reported previously as an occupational lung disease in dry cleaners. We conclude that HP should be suspected in dry cleaners presenting with pulmonary complaints, and TCE should be considered as a potential trigger of disease. The spectrum of TCE-related occupational diseases and the diagnosis of HP are reviewed.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Tufts University School of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA. mtanios@tufts-nemc.org
authors.forename: Maged A
authors.initials: MA
authors.lastname: Tanios
authors.forename: Hesham
authors.initials: H
authors.lastname: El Gamal
authors.forename: Beth J
authors.initials: BJ
authors.lastname: Rosenberg
authors.forename: Paul M
authors.initials: PM
authors.lastname: Hassoun
mesh_terms: D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D006801:Humans; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure; D012129:Respiratory Function Tests; D012997:Solvents / Q000009:adverse effects*; D013750:Tetrachloroethylene / Q000009:adverse effects*
chemical_list: D012997:Solvents; D013750:Tetrachloroethylene