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Oh, Cho, Baek, Cho, Kang, Kim, and Kwak: A Case of Hypersensitivity Pneumonitis in an Automobile Paint Sprayer
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(6): 541-545.

Published online: 31 December 2008

DOI: https://doi.org/10.4046/trd.2008.65.6.541

A Case of Hypersensitivity Pneumonitis in an Automobile Paint Sprayer

Mi Na Oh, M.D., Myoung Jin Cho, M.D., Hoon Ki Baek, M.D., Ki Sung Cho, M.D., Ji Hoon Kang, M.D., Young Kim, M.D., Jin Young Kwak, M.D.

Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.

Address for correspondence: Jin Young Kwak, M.D. Departmet of Internal Medicine, Presbyterian Medical Center, 344-2, Jungwhasan-dong, Wansan-gu, Jeonju 570-711, Korea. Phone: 82-63-230-8902, Fax: 82-63-230-8917, dnjao@yahoo.co.kr

Received 23 September 2008       Accepted 14 October 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Hypersensitivity pneumonitis (HP) is an immunologically-mediated disease resulting from repeated exposure to sensitizing agents, such as organic dusts or chemicals. Isocyanate is a volatile and highly reactive chemical that is extensively used in the manufacturing of automobiles, upholstery, and polyurethane foam. Occupational respiratory diseases associated with isocyanate, such as bronchial asthma, are well-known. It is thought that HP is one of the rare diseases induced by isocyanate with a very low frequency worldwide. We report a case of HP in an automobile painting sprayer which appeared to be associated with isocyanate.

Keywords: Hypersensitivity pneumonitis, Isocyanate, Paint sprayer

Figures and Tables

Figure 1
Initial chest PA shows diffuse ground glass opacities in both lung fields (A). Follow up chest PA (24 days later), diffuse ground glass opacities are nearly improved (B).
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Figure 2
Chest CT on admission shows diffuse centrilobular nodules and ground glass opacity lesions (A, B).
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Figure 3
Transbronchial biopsy reveals interstitial infiltration of inflammatory cell infiltration (A, H&E stain, ×40) and non-necrotizing granuloma (B, H&E stain, ×100).
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Table 1
Proposed diagnostic criteria for hypersensitivity pneumonitis for clinical purpose Major Criteria
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HP: hypersensitivity pneumonitis; BAL: bronchoalveolar lavage; HRCT: high-resolution computed tomography; DLCO: diffusing capacity of the lung for carbon monoxide.

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