Immunoglobulin E—mediated asthma and hypersensitivity pneumonitis with precipitating anti-hapten antibodies due to diphenylmethane diisocyanate (MDI) exposure

Isocyanate exposure and hypersensitivity pneumonitis--report of a probable case and prevalence of specific immunoglobulin G antibodies among exposed individuals.

“…Sporadic cases of hypersensit ivity pneumonitis have been reported in association with exposure to isocyanates, ie, toluene diisocyanate (TOI) (1-4), diphenylmethane diisocyanate (MOl) (5)(6)(7)(8)(9), and hexamethylene diisocyanate (HOI) (1, 4,10), although the case definition has been incon sistent. Specific serum antibodies of the immunoglobulin (Ig) G class against pertinent diisocyanates have been found in some instances (7,(9)(10)(11)(12) but not in others.…”

“…Specific serum antibodies of the immunoglobulin (Ig) G class against pertinent diisocyanates have been found in some instances (7,(9)(10)(11)(12) but not in others. Thi s communication reports a probable case of hyper sensitivity pneumonitis after exposure to prepolymerized HDI.…”

Diisocyanate [MAK Value Documentation in German language, 1984]

“…Für pharmakologische Pathomechanismen sprechen Hemmeffekte der Isocyanate auf Cholinesterase [61,62] und auf das Adenyl-Cyclase-System [63][64][65][66]. Eine sehr seltene Form der respiratorischen Sensibilisierung durch Isocyanate ist die exogene allergische Alveolitis mit einem fieberhaften, grippeähnlichen Krankheitsbild [67][68][69][70][71][72][73]. Spezifische IgG sind hierbei in der Regel nachweisbar; die Lungenbiopsic läßt charakteristische Veränderungen erkennen.…”

Health hazard evaluation report: HETA-86-162-1782, Continental Refrigeration Corporation, Exton, Pennsylvania.

“…Chronic effects that have been reported include excess declines in the forced expiratory volume in 1 second (FEV 1 ) and the forced vital capacity (FVC), increased prevalence of bronchitis and dyspnea and possibly, hypersensitivity pneumonitis. 7,8,9,10 6. Solvents…”