Extrinsic allergic alveolitis with eosinophil infiltration induced by 1,1,1,2-tetrafluoroethane (HFC-134a): a case report.
A 22-year-old woman was admitted with symptoms of dyspnea and fever with pulmonary infiltrates noted on her chest X-ray study. She developed these symptoms in the workplace; her job included the removal of body hair using a diode-laser with 1,1,1,2-tetrafluoroethane (HFC134a, an alternative to chlorofluorocarbon) as a coolant. A chest X-ray examination revealed ground-glass opacities in the lower lung fields, and a chest computed tomographic study showed diffuse centrilobular opacities. An examination of the bronchoalveolar lavage fluid revealed increased lymphocytes with a slight increase in the number of eosinophils. An examination of the transbronchial biopsy specimens revealed eosinophil infiltration. A peripheral blood eosinophilia was also seen. The patient's symptoms, chest X-ray findings, and arterial blood gas analysis all returned to normal within a week. A challenge test of 1,1,1,2-tetrafluoroethane (HFC134a) inhalation was performed, which resulted in an elevation of body temperature, the development of a cough, and laboratory data indicating increased inflammation. We then determined the patient's diagnosis to be extrinsic allergic alveolitis with eosinophil infiltration, caused by HFC134a.
Ishiguro
Takashi
T
Respiratory Medicine, Cellular Transplantation Biology, Graduate School of Medicine, Kanazawa University. ishiguro@med3.m.kanazawa-u.ac.jp
Yasui
Masahide
M
Nakade
Yusuke
Y
Kimura
Hideharu
H
Katayama
Nobuyuki
N
Kasahara
Kazuo
K
Fujimura
Masaki
M
D000328:Adult; D000335:Aerosol Propellants / Q000009:adverse effects*; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced*; D004802:Eosinophilia / Q000209:etiology*; D005260:Female; D006204:Hair Removal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects*; D009784:Occupational Diseases; D016273:Occupational Exposure / Q000009:adverse effects*; D004980:Ethane / Q000031:analogs & derivatives; D005466:Fluorocarbons