title: Hard metal lung disease successfully treated with inhaled corticosteroids.
abstract: We herein report a case of hard metal lung disease that was successfully treated with inhaled corticosteroids. A 46-year-old man was admitted to our hospital due to coughing and an abnormal shadow on a chest radiograph. He had worked as a hard metal tool sharpener for five years. Chest computed tomography scans showed centrilobular micronodules and areas of ground-glass opacity in the bilateral lung fields. Video-associated lung biopsy specimens revealed bronchocentric interstitial pneumonia and cellular bronchiolitis. A high-energy dispersion X-ray microanalysis detected tungsten. The patient was diagnosed with hard metal lung disease. Inhaled corticosteroid therapy (800 μg of ciclesonide hydrofluoroalkane daily) resolved the patient's symptoms, elevated KL-6 level, abnormal areas of chest opacity and obstructive, restrictive and diffusion impairments.
authors.affiliation: Department of Internal Medicine 3, Oita University Faculty of Medicine, Japan. nureki@oita-u.ac.jp
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nureki
authors.forename: Eishi
authors.initials: E
authors.lastname: Miyazaki
authors.forename: Suehiro
authors.initials: S
authors.lastname: Nishio
authors.forename: Masaru
authors.initials: M
authors.lastname: Ando
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kumamoto
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000497:Alloys / Q000009:adverse effects*; D003035:Cobalt / Q000009:adverse effects*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016896:Treatment Outcome; D014414:Tungsten / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D000497:Alloys; C080121:hard metal; D003035:Cobalt; D014414:Tungsten