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一名钻石抛光工人在停止职业接触后因氯化钴引起的职业性哮喘:病例报告

Occupational asthma caused by cobalt chloride in a diamond polisher after cessation of occupational exposure: a case report.

作者信息

Krakowiak Anna, Dudek Wojciech, Tarkowski Maciej, Swiderska-Kiełbik Sylwia, Nieścierenko Ewa, Pałczyński Cezary

机构信息

Department of Occupational Diseases, Center of Occupational and Environmental Allergy, Nofer Institute of Occupational Medicine, Lódź, Poland.

出版信息

Int J Occup Med Environ Health. 2005;18(2):151-8.

Abstract

OBJECTIVES

The inspiration of cobalt containing dust leads to various respiratory symptoms, including asthma and interstitial lung disease. Occupational asthma caused by cobalt chloride has been diagnosed in a 35-year-old patient, who worked as a diamond polishing disc former. The patient presented a 2-year history of dyspnea, cough and symptoms of rhinitis.

MATERIALS AND METHODS

The patient underwent a medical history interview, skin prick tests with common and occupational allergens (cobalt and nickel chloride), and pulmonary function testing both before and after the nasal provocation with 0.05% cobalt chloride. Additionally, the authors analyzed morphological and biochemical changes before and after the specific nasal challenge test. Cell proliferation analysis was also carried out.

RESULTS

Skin prick tests (SPTs) with common environmental allergens were found to be negative, while SPTs with cobalt chloride were positive for all applied solutions. The provocation with cobalt chloride caused a significant increase in the proportion of eosinophils, basophils and albumin during the late allergic reaction. The positive lymphocyte transformation caused by cobalt was also observed.

CONCLUSIONS

Cobalt salts may induce occupational asthma. The mechanism of this asthma may be IgE-mediated. The cobalt-sensitized lymphocytes may play an important role in this disease.

摘要

目的

吸入含钴粉尘会引发多种呼吸道症状,包括哮喘和间质性肺病。一名35岁从事金刚石抛光盘成型工作的患者被诊断为氯化钴所致的职业性哮喘。该患者有2年的呼吸困难、咳嗽及鼻炎症状病史。

材料与方法

对患者进行了病史询问、用常见及职业性变应原(氯化钴和氯化镍)进行皮肤点刺试验,以及在0.05%氯化钴鼻激发试验前后进行肺功能测试。此外,作者分析了特异性鼻激发试验前后的形态学和生化变化。还进行了细胞增殖分析。

结果

发现对常见环境变应原的皮肤点刺试验(SPT)为阴性,而对所有应用溶液的氯化钴皮肤点刺试验均为阳性。氯化钴激发试验在迟发性过敏反应期间导致嗜酸性粒细胞、嗜碱性粒细胞比例及白蛋白显著增加。还观察到钴引起的淋巴细胞转化阳性。

结论

钴盐可能诱发职业性哮喘。这种哮喘的机制可能是IgE介导的。钴致敏淋巴细胞可能在该疾病中起重要作用。

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