Miyazaki Hiroo, Hirata Takeo, Shimane Shoko, Morita Sumihito, Chihara Koji, Enomoto Noriyuki, Suda Takafumi, Chida Kingo
Department of Respiratory Medicine, Shizuoka City Hospital.
Nihon Kokyuki Gakkai Zasshi. 2006 Dec;44(12):985-9.
A 55-year-old man with a 3-year occupational history of welding was admitted for repeated episodes of fever, cough and dyspnea after inhalation of smoke while welding galvanized steel. A computed tomography (CT) showed diffuse centrilobular nodules, panlobular ground-glass opacity and interlobular septal thickening in both lung fields, and he suffered from hypoxemia (PaO2 = 55.3Torr) while breathing room air. Percentage of lymphocytes in bronchoalveolar lavage fluid increased, and lung biopsy specimens at thoracoscopy revealed lymphocytic alveolitis and organization in air spaces. His symptoms and signs disappeared spontaneously only when he ceased welding. Panlobular ground-glass opacity and interlobular septal thickening improved immediately with oral corticosteroids. Patch tests using metal series gave positive reactions to zinc. We diagnosed this case as hypersensitivity pneumonitis caused by zinc fumes.
一名55岁男性,有3年焊接工作史,因在焊接镀锌钢时吸入烟雾后反复出现发热、咳嗽和呼吸困难入院。计算机断层扫描(CT)显示双肺野弥漫性小叶中心结节、全小叶磨玻璃影和小叶间隔增厚,在呼吸室内空气时他存在低氧血症(动脉血氧分压[PaO2]=55.3托)。支气管肺泡灌洗液中淋巴细胞百分比增加,胸腔镜下肺活检标本显示淋巴细胞性肺泡炎和气腔机化。仅当他停止焊接时,其症状和体征才自行消失。口服糖皮质激素后,全小叶磨玻璃影和小叶间隔增厚立即改善。使用金属系列进行的斑贴试验对锌呈阳性反应。我们将该病例诊断为锌烟引起的过敏性肺炎。