Charles J, Bernstein A, Jones B, Jones D J, Edwards J H, Seal R M, Seaton A
Thorax. 1976 Apr;31(2):127-36. doi: 10.1136/thx.31.2.127.
Four patients exposed to isocyanate vapour developed dyspnoea associated with restriction and reduced gas transfer as well as moderate airways obstruction on lung function testing. In one patient bilateral radiographic shadowing was present and an open lung biopsy was performed. The microscopic appearances ranged from acute inflammation to end-stage fibrosis but the centribular accentuation of disease and the presence of areas resembling bronchopulmonary aspergillosis suggested that the process was a hypersensitivity response to inhaled allergen. Challenge tests with albumin and toluene diisocyanate-albumin were carried out in sensitized and control rabbits. The sensitized animals developed extensive lung damage of the type associated with an Arthus reaction. It is suggested that patients exposed to isocyanates may occasionally develop a hypersensitivity pneumonitis rather than the more usual asthmatic syndrome.
4名接触异氰酸酯蒸气的患者出现呼吸困难，伴有肺功能受限、气体交换减少以及中度气道阻塞。1例患者出现双侧影像学阴影，并进行了开胸肺活检。显微镜下表现从急性炎症到终末期纤维化不等，但病变的小叶中心性加重以及存在类似支气管肺曲霉菌病的区域提示该过程是对吸入变应原的超敏反应。对致敏兔和对照兔进行了白蛋白和甲苯二异氰酸酯 - 白蛋白激发试验。致敏动物出现了与阿瑟反应相关的广泛肺损伤。提示接触异氰酸酯的患者偶尔可能发生超敏性肺炎，而非更常见的哮喘综合征。
