Inoue S, Suzumura Y, Takahashi K
Department of Thoracic Surgery, Minami-Kyoto Hospital of National Sanatorium, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Sep;32(9):861-6.
A 48-year-old man who had been a welder for 25 years was admitted to our hospital on February 18, 1990 for investigation of a diffuse bilateral lung shadow that had a ground-glass appearance. On the day of admission, he had been welding copper water supply pipe and used silver brazing with an oxyacetylene torch. After almost 7 hours of work, he had a chill, high fever, and dyspnea. Blood gas analysis revealed severe hypoxemia (PaO2 34.5 Torr, PaCO2 29.4 Torr). The level of copper in serum was slightly higher than normal (174 micrograms/dl). A transbronchial lung biopsy specimen showed lymphocyte infiltration and fibrous changes of the alveolar walls, which seemed to be granulomatous pneumonitis. Steroid therapy was effective against the symptoms, and the radiographic findings also improved. We think this is a rare case of interstitial pneumonitis caused by inhalation of cadmium fumes contained in silver brazing.
一名48岁男性，从事焊接工作25年，于1990年2月18日因双肺弥漫性磨玻璃样阴影入院检查。入院当天，他正在焊接铜质供水管，并使用氧乙炔焊炬进行银钎焊。工作近7小时后，他出现寒战、高热和呼吸困难。血气分析显示严重低氧血症（动脉血氧分压34.5托，动脉血二氧化碳分压29.4托）。血清铜水平略高于正常（174微克/分升）。经支气管肺活检标本显示淋巴细胞浸润及肺泡壁纤维性改变，似为肉芽肿性肺炎。类固醇治疗对症状有效，影像学表现也有所改善。我们认为这是一例因吸入银钎焊中所含镉烟导致的间质性肺炎罕见病例。
