title: Occupational asthma due to manganese exposure: a case report.
abstract: Manganese belongs to a group of agents called "transitional metals" that are known to induce occupational asthma. However, well-documented cases of manganese-induced asthma have been lacking thus far. We have discussed a case of a 42-year-old non-smoking welder with work-related dyspnea. A number of clinical procedures were performed including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens and manganese nitrate, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with 0.1% manganese chloride solution. Clinical findings and laboratory test results remained normal but a significant bronchial hyperreactivity was found. During the specific inhalation challenge, dyspnea and a significant decrease in forced expiratory volume (FEV1) were observed. An increased proportion of eosinophils and basophils in induced sputum could also be noted at 4 and 24 h after the challenge. The argument for recognizing the condition as occupational asthma was a positive clinical response to the specific challenge test as well as the morphological changes found in induced sputum. To our knowledge, this is the first well-documented case of manganese-induced occupational asthma.
authors.affiliation: Department of Occupational Diseases, Centre of Occupational and Environmental Allergy, Nofer Institute of Occupational Medicine, Łódź, Poland. tomekwit@imp.lodz.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wittczak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dudek
authors.forename: Anna
authors.initials: A
authors.lastname: Krakowiak
authors.forename: Jolanta
authors.initials: J
authors.lastname: Walusiak
authors.forename: Cezary
authors.initials: C
authors.lastname: Pałczyński
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008345:Manganese / Q000008:administration & dosage / Q000009:adverse effects*; D020149:Manganese Poisoning / Q000503:physiopathology; D016273:Occupational Exposure; D011044:Poland
chemical_list: D008345:Manganese