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Chest, Vol 89, 389-393, Copyright © 1986 by American College of Chest Physicians

ARTICLES

Absence of hyperresponsiveness to methacholine in a worker with methylene diphenyl diisocyanate (MDI)-induced asthma

DE Banks, HW Barkman Jr, BT Butcher, YY Hammad, RJ Rando, HW Glindmeyer 3d, RN Jones and H Weill

A 29-year-old man had a persuasive history of respiratory illness following exposures to methylene diphenyl diisocyanate (MDI). He was evaluated by measuring bronchial reactivity to methacholine, both before and after controlled laboratory exposures to MDI. Despite evidence of progressive declines in FEV1 with increasing (but subirritant) doses of MDI on three consecutive days, there was no bronchial hyperresponsiveness to methacholine, before or after MDI challenge. We conclude that the absence of nonspecific bronchial hyperresponsiveness does not exclude the possibility of isocyanate asthma. In the face of a compelling history, a negative result of methacholine challenge should not deter observation or laboratory testing for specific respiratory allergy to these chemicals.


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O. Vandenplas and J-L. Malo
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[Abstract] [Full Text] [PDF]

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H. G. Ortega, D. N. Weissman, D. L. Carter, and D. Banks
Use of Specific Inhalation Challenge in the Evaluation of Workers at Risk for Occupational Asthma* : A Survey of Pulmonary, Allergy, and Occupational Medicine Residency Training Programs in the United States and Canada
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