Liippo K K, Anttila S L, Taikina-Aho O, Ruokonen E L, Toivonen S T, Tuomi T
Department of Diseases of the Chest, Turku University Central Hospital, Finland.
Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):1089-92. doi: 10.1164/ajrccm/148.4_Pt_1.1089.
We describe a nonsmoking ceramic tile worker 25 yr of age who developed a worsening dry cough and dyspnea after 3.5 yr as a sorter and glazer of tiles. Open lung biopsy revealed an intense granulomatous interstitial pneumonia with mild fibrosis, compatible with hypersensitivity pneumonitis, and numerous very small birefringent crystals around the terminal airways and occasionally in granulomas. Pulmonary particle analysis revealed an inhaled dust burden nearly 100-fold the normal background level, mainly consisting of clay minerals and zirconium silicate. The patient had no history or clinical or laboratory findings suggesting any organic etiologic agent. A sarcoid granulomatosis type of chronic pulmonary hypersensitivity reaction is known after long-term exposure to zirconium, but this case demonstrates that zirconium can also cause an acute and fulminant allergic alveolitislike hypersensitivity reaction.
我们描述了一名25岁的不吸烟瓷砖工人，他在从事瓷砖分拣和上釉工作3.5年后，干咳和呼吸困难症状逐渐加重。开胸肺活检显示为严重的肉芽肿性间质性肺炎伴轻度纤维化，符合过敏性肺炎，终末气道周围及偶尔在肉芽肿内可见大量非常小的双折射晶体。肺部颗粒分析显示吸入的粉尘负荷几乎是正常背景水平的100倍，主要由粘土矿物和硅酸锆组成。该患者无任何提示任何有机病原体的病史、临床或实验室检查结果。长期接触锆后已知会发生结节病样慢性肺部过敏反应，但该病例表明锆也可引起急性暴发性过敏性肺泡炎样过敏反应。
