title: Hard metal lung disease diagnosed on a transbronchial lung biopsy following recurrent contact dermatitis.
abstract: A 63-year-old man employed in a hard metal manufacturing company for 40 years presented with a chronic dry cough and exertional dyspnea 20 years after the onset of recurrent exanthemas. A chest radiograph revealed bilateral reticular shadows in the upper lung field. Pathological specimens in which tungsten was detected were obtained via a transbronchial lung biopsy. Patch tests were positive for cobalt and other metals. The patient was diagnosed with hard metal lung disease (HMLD) concurrent with contact dermatitis and treated with corticosteroids. This case suggests that allergies to metal may play a role in the onset of HMLD.
authors.affiliation: Department of Respiratory Medicine, Osaka Red Cross Hospital, Japan.
authors.forename: Yasukiyo
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nishizaka
authors.forename: Ryo
authors.initials: R
authors.lastname: Ariyasu
authors.forename: Natsumi
authors.initials: N
authors.lastname: Okamoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshida
authors.forename: Masato
authors.initials: M
authors.lastname: Taki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Kenji
authors.initials: K
authors.lastname: Hanaoka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Chie
authors.initials: C
authors.lastname: Yoshimura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Wakayama
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Amitani
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D003035:Cobalt / Q000009:adverse effects / Q000032:analysis; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004577:Electron Probe Microanalysis; D005355:Fibrosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008168:Lung / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008669:Metallurgy; D019216:Metals, Heavy / Q000009:adverse effects* / Q000032:analysis; D008875:Middle Aged; D010328:Patch Tests; D011009:Pneumoconiosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D014414:Tungsten / Q000009:adverse effects / Q000032:analysis
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D019216:Metals, Heavy; D003035:Cobalt; D014414:Tungsten