Doença pulmonar por metal duro em trabalhador da indústria petrolífera

Abstract

A 50-year-old male patient sought treatment at our facility. He had worked as an industrial plumber on an oil platform for 9 years and had been admitted to another hospital in 1996 for the investigation of dyspnea on exertion, mild productive cough, evening fever and arthralgia (all of which had started 5 years before that admission and had worsened 3 months prior). The patient reported having been treated for pneumonia on four occasions, with temporary improvement, had a history of systemic arterial hypertension and was a former smoker (20 pack-years) who had not smoked for 5 years. A chest X-ray showed bilateral interstitial infiltrate ( Figure 1a) IntroductionLung diseases secondary to dust inhalation and presenting an immune response mechanism involving hypersensitivity, as is the case of hard metal lung disease, tend to be designated based on histopathological aspects or pathophysiological mechanisms, despite meeting some of the criteria of pneumoconioses. Inhalation of hard metal dust is a type of occupational exposure that is rarely investigated. There is an inflammatory process that can evolve progressively, causing significant impairment of respiratory function and gas exchange, as well as considerable morbidity and mortality. We report a case of lung disease due to exposure to hard metals. The diagnosis was based on the investigation of the occupational exposure, together with the review of the clinical, radiological and histopathological findings. AbstractHard metal lung disease, which manifests as giant cell interstitial pneumonia, is caused by exposure to hard metal dust. We report the case of an oil industry worker diagnosed with hard metal lung disease. The diagnosis was based on the clinical, radiological and anatomopathological analysis, as well as on pulmonary function testing.Keywords: Alloys/adverse effects; Cobalt; Tungsten; Occupational exposure; Lung diseases, interstitial. ResumoA doença pulmonar por metal duro é uma pneumonia intersticial por células gigantes relacionada com a exposição à poeira composta por metais duros. Neste artigo é relatado o caso de um profissional da indústria petrolífera, diagnosticado com doença pulmonar por metal duro com base na documentação clínica, radiológica, funcional pulmonar e anatomopatológica.Descritores: Ligas/efeitos adversos; Cobalto; Tungstênio; Exposição ocupacional; Doenças pulmonares intersticiais. Case ReportHard metal lung disease in an oil industry worker

Hard metal lung disease: a case series

“…Because of the scarcity of cases in the literature, there have been no studies comparing corticosteroid therapy and placebo treatment; however, clinical experience is that corticosteroid therapy results in improvement 9 30 The use of immunosuppressive therapy also is not well established, although immunosuppressants are occasionally used 9 . Lung transplantation is a treatment option in patients with advanced lung disease that progresses despite treatment, 31 despite the possibility of GIP pattern recurrence in the transplanted lung 6 …”

Fluro-deoxyglucose-positron emission tomography/computed tomography in hard metal lung disease

“…In a study by Bezerra et al , treatment with immunosuppressant (azathioprine and pulses of cyclophosphamide) and prednisone showed good clinical improvement. [ 23 ]…”