Case Report of Occupational Asthma Induced by Polyvinyl Chloride and Nickel

Abstract

Polyvinyl chloride (PVC) is a widely used chemical for production of plastics. However occupational asthma (OA) caused by PVC has been reported only rarely. We report a 34-yrold male wallpaper factory worker with OA due to PVC and nickel (Ni) whose job was mixing PVC with plasticizers. He visited the emergency room due to an asthma attack with moderate airflow obstruction and markedly increased sputum eosinophil numbers. A methacholine challenge test was positive (PC20 2.5 mg/mL). Bronchoprovocation tests with both PVC and Ni showed early and late asthmatic responses, respectively. Moreover, the fractional concentration of exhaled nitric oxide (FeNO) was increased after challenge with PVC. To our knowledge, this is the first case of OA in Korea induced by exposure to both PVC and Ni. We suggest that eosinophilic inflammation may be involved in the pathogenesis of PVC-induced OA and that FeNO monitoring can be used for its diagnosis.

Hypereosinophilic syndrome manifested as eosinophilic gastroenteritis and colitis in a patient undergoing hemodialysis

“…To date, seven cases with eosinophilia and clinical symptoms due to nickel including our case had been described [13][14][15][16][17][18]. Gray reported the first case of a patient who developed eosinophilia due to ingestion of a nickel coin and presented with Loffler's syndrome, transient migratory infiltrates associated with peripheral eosinophilia [13].…”

“…Gray reported the first case of a patient who developed eosinophilia due to ingestion of a nickel coin and presented with Loffler's syndrome, transient migratory infiltrates associated with peripheral eosinophilia [13]. Four cases of occupational asthma with HE associated with exposure to nickel dust have been previously reported [14][15][16][17]. These five cases had transient mild eosinophilic pneumonia [13,14] or asthma [15][16][17] that could be treated with low-dose corticosteroid.…”

“…Four cases of occupational asthma with HE associated with exposure to nickel dust have been previously reported [14][15][16][17]. These five cases had transient mild eosinophilic pneumonia [13,14] or asthma [15][16][17] that could be treated with low-dose corticosteroid. Meanwhile, Fung et al reported a case of fulminant HE and eosinophilic myocarditis triggered by the nickel in implantable cardioverter-defibrillator components superimposed on advanced non-ischemic dilated cardiomyopathy, who eventually needed cardiac transplantation [18].…”

“…Previous reports of hypereosinophilia due to nickel[13][14][15][16][17][18] ICD implantable cardioverter-defibrillator, C.T. cardiac transplantation, EGIDs eosinophilic gastrointestinal disorders, i.v.…”

Рядък Случай На Рецидивиращ Ангиоедем И Дебютирала Астма С Професионална Етиология При Пациент С Тиреотоксикоза

“…Представлява полимеризирана форма на винилхлорид, който се използва широко в производството на изделия за бита и промишлеността като синтетична кожа, тапети, подови настилки и много други [8]. Въпреки това професионалната астма, причинена от PVC, е докладвана рядко [9].…”