title: Interstitial pneumonitis after acetylene welding: a case report.
abstract: Acetylene is a colorless gas commonly used for welding. It acts mainly as a simple asphyxiant. In this paper, however, we present a patient who developed a severe interstitial pneumonitis after acetylene exposure during aluminum welding. A 44-year old man was welding with acetylene, argon and aluminum electrode sticks in a non-ventilated aluminum tank for 2 h. Four hours after welding dyspnea appeared and 22 h later he was admitted at the Emergency Department due to severe respiratory insufficiency with pO2 = 6.7 kPa. Chest X-ray showed diffuse interstitial infiltration. Pulmonary function and gas diffusion tests revealed a severe restriction (55% of predictive volume) and impaired diffusion capacity (47% of predicted capacity). Toxic interstitial pneumonitis was diagnosed and high-dose systemic corticosteroid methylprednisolone and inhalatory corticosteroid fluticasone therapy was started. Computed Tomography (CT) of the lungs showed a diffuse patchy ground-glass opacity with no signs of small airway disease associated with interstitial pneumonitis. Corticosteroid therapy was continued for the next 8 weeks gradually reducing the doses. The patient's follow-up did not show any deterioration of respiratory function. In conclusion, acetylene welding might result in severe toxic interstitial pneumonitis that improves after an early systemic and inhalatory corticosteroid therapy.
authors.affiliation: Poison Control Centre, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia, miran.brvar@kclj.si.
authors.forename: Miran
authors.initials: M
authors.lastname: Brvar
mesh_terms: D000114:Acetylene / Q000633:toxicity*; D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D000068298:Fluticasone; D005740:Gases / Q000633:toxicity*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009784:Occupational Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D014896:Welding
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D005740:Gases; D000068298:Fluticasone; D000114:Acetylene; D008775:Methylprednisolone