Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1976 Apr;31(2):127–136. doi: 10.1136/thx.31.2.127

Hypersensitivity pneumonitis after exposure to isocyanates.

J Charles, A Bernstein, B Jones, D J Jones, J H Edwards, R M Seal, A Seaton
PMCID: PMC470374  PMID: 181861

Abstract

Four patients exposed to isocyanate vapour developed dyspnoea associated with restriction and reduced gas transfer as well as moderate airways obstruction on lung function testing. In one patient bilateral radiographic shadowing was present and an open lung biopsy was performed. The microscopic appearances ranged from acute inflammation to end-stage fibrosis but the centribular accentuation of disease and the presence of areas resembling bronchopulmonary aspergillosis suggested that the process was a hypersensitivity response to inhaled allergen. Challenge tests with albumin and toluene diisocyanate-albumin were carried out in sensitized and control rabbits. The sensitized animals developed extensive lung damage of the type associated with an Arthus reaction. It is suggested that patients exposed to isocyanates may occasionally develop a hypersensitivity pneumonitis rather than the more usual asthmatic syndrome.

Full text

PDF
132

Images in this article

129Image
on p.129
129Image
on p.129
130Image
on p.130
131Image
on p.131
131Image
on p.131
132Image
on p.132
132Image
on p.132
133Image
on p.133
133Image
on p.133

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ann Arbor case reports. I. Asthma and toluene di-isocyanate exposure. J Occup Med. 1966 Feb;8(2):81–83. [PubMed] [Google Scholar]
  2. BLAKE B. L., MACKAY J. B., RAINEY H. B., WESTON W. J. PULMONARY OPACITIES RESULTING FROM DI-ISOCYANATE EXPOSURE. J Coll Radiol Australas. 1965 Feb;9:45–48. doi: 10.1111/j.1440-1673.1965.tb00974.x. [DOI] [PubMed] [Google Scholar]
  3. BOYDEN S. V. The adsorption of proteins on erythrocytes treated with tannic acid and subsequent hemagglutination by antiprotein sera. J Exp Med. 1951 Feb;93(2):107–120. doi: 10.1084/jem.93.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BRADSTREET C. M., TAYLOR C. E. Technique of complementfixation test applicable to the diagnosis of virus diseases. Mon Bull Minist Health Public Health Lab Serv. 1962 May;21:96–104. [PubMed] [Google Scholar]
  5. BRUGSCH H. G., ELKINS H. B. Toluene di-isocyanate (TDI) toxicity. N Engl J Med. 1963 Feb 14;268:353–357. doi: 10.1056/NEJM196302142680705. [DOI] [PubMed] [Google Scholar]
  6. Bruckner H. C., Avery S. B., Stetson D. M., Dodson V. N., Ronayne J. J. Clinical and immunologic appraisal of workers exposed to diisocyanates. Arch Environ Health. 1968 May;16(5):619–625. doi: 10.1080/00039896.1968.10665117. [DOI] [PubMed] [Google Scholar]
  7. Hill R. N. A controlled study of workers handling organic diisocyanates. Proc R Soc Med. 1970 Apr;63(4):375–375. [PMC free article] [PubMed] [Google Scholar]
  8. Niewenhuis R., Scheel L., Stemmer K., Killens R. Toxicity of chronic low level exposures to toluene diisocyanate in animals. Am Ind Hyg Assoc J. 1965 Mar-Apr;26(2):143–149. doi: 10.1080/00028896509342714. [DOI] [PubMed] [Google Scholar]
  9. Peters J. M. Studies of isocyanate toxicity. Proc R Soc Med. 1970 Apr;63(4):372–375. [PMC free article] [PubMed] [Google Scholar]
  10. ROWE D. S., FAHEY J. L. A NEW CLASS OF HUMAN IMMUNOGLOBULINS. II. NORMAL SERUM IGD. J Exp Med. 1965 Jan 1;121:185–199. doi: 10.1084/jem.121.1.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. SCHEEL L. D., KILLENS R., JOSEPHSON A. IMMUNOCHEMICAL ASPECTS OF TOLUENE DIISOCYANATE (TDI) TOXICITY. Am Ind Hyg Assoc J. 1964 Mar-Apr;25:179–184. doi: 10.1080/00028896409342574. [DOI] [PubMed] [Google Scholar]
  12. SILVER H. M. TOLUENE DIISOCYANATE ASTHMA. REVIEW AND CASE REPORT WITH RESPONSE TO STEROIDS. Arch Intern Med. 1963 Sep;112:401–404. doi: 10.1001/archinte.1963.03860030155018. [DOI] [PubMed] [Google Scholar]
  13. Stevens M. A., Palmer R. The effect of tolylene diisocyanate on certain laboratory animals. Proc R Soc Med. 1970 Apr;63(4):380–382. [PMC free article] [PubMed] [Google Scholar]
  14. TRENCHARD H. J., HARRIS W. C. An outbreak of respiratory symptoms caused by toluene di-isocyanate. Lancet. 1963 Feb 23;1(7278):404–406. doi: 10.1016/s0140-6736(63)92300-6. [DOI] [PubMed] [Google Scholar]
  15. Taylor G. Immune responses to tolylene diisocyanate (TDI) exposure in man. Proc R Soc Med. 1970 Apr;63(4):379–380. [PMC free article] [PubMed] [Google Scholar]
  16. WOODBURY J. W. Asthmatic syndrome following exposure to tolylene diisocyanate. Ind Med Surg. 1956 Nov;25(11):540–543. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES