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(Chest. 1995;108:1196-1200.)
© 1995 American College of Chest Physicians

Desquamative Interstitial Pneumonitis and Diffuse Alveolar Damage in Textile Workers

Potential Role of Mycotoxins

M. Diane Lougheed MD, FCCP1; Jaan O. Roos MD, FCCP2; William R. Waddell MD2; and Peter W. Munt MD, FCCP1

1 From the Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
2 From the Ontario Ministry of Labour

Five of 88 workers at a textile plant developed interstitial lung disease. Biopsy specimens from the three initial cases demonstrated desquamative interstitial pneumonitis and diffuse alveolar damage. Two of these patients developed hypoxemic respiratory failure despite high-dose corticosteroid therapy. A survey of the remaining textile workers (questionnaires, chest radiographs, and pulmonary function tests) revealed one new case. This patient, and one other with a compatible presentation, improved clinically upon leaving the workplace and did not require therapy. A comprehensive assessment of the work environment was performed in search of potentially toxic respirable agents. We propose that these cases represent desquamative interstitial pneumonitis-like reactions, occupationally related to aflatoxin inhalation.

Key Words: desquamative interstitial pneumonitis • diffuse alveolar damage • mycotoxins

Submitted on August 24, 1994
Accepted on June 9, 1995




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