title: Two cases of hard metal lung disease showing gradual improvement in pulmonary function after avoiding dust exposure.
abstract: We present herein two cases of hard metal lung disease (HMLD) with distinct pathological findings. Both cases showed gradual improvements in pulmonary function over a period of a few years (Case 1: 30 months; Case 2: 12 months) after the avoidance of dust exposure, while improvements on high-resolution computed tomography were modest. The increased lymphocytes and decreased CD4/CD8 ratio in BALF observed at initial diagnosis normalized after the avoidance of dust exposure in one case. To the best of our knowledge, this is the first report demonstrating continual follow-up of pulmonary function and radiographic findings, and a comparison of BALF findings before and after avoidance of hard metal dust exposure.
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, Kita-15 Nishi-7 Kita-Ku, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Terui
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, Kita-15 Nishi-7 Kita-Ku, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Konno
authors.affiliation: Cardiovascular and Thoracic Surgery, Hokkaido University School of Medicine, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Kichizo
authors.initials: K
authors.lastname: Kaga
authors.affiliation: Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsuno
authors.affiliation: Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Kanako C
authors.initials: KC
authors.lastname: Hatanaka
authors.affiliation: Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanno
authors.affiliation: Niigata University Medical & Dental Hospital Bioscience Medical Research Center, Niigata, Niigata 951-8520 Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
authors.affiliation: Advanced Biomaterials, Department of Restorative Sciences, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8549 Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Uo
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, Kita-15 Nishi-7 Kita-Ku, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
keywords: Avoidance; BALF; Dust exposure; Hard metal lung disease; Pulmonary function