Progressive pulmonary fibrosis

Direct entry of alumina adjuvants through the skin may occur by the use of therapeutic vaccines, with a resultant transient uptake of aluminium in the brain (Redhead et al., 1992). The injection of talc (magnesium silicate)-containing drugs intended for oral consumption has been shown to induce progressive pulmonary fibrosis in drug abusers (Pare etal., 1989). 

Beagle dog inhalation l44Ce in fused aluminosilicate particles AMAD 1.6-2.2 pm o 1.3-1,6 3 mos 54 life span (in progress) pulmonary fibrosis, radiation pneumonitis, congenital heart failure 5/12 Yes hemangiosarcoma 4/12 Yes No hemangiosar- coma 1/12 Hanicka-Rebar (1978)... 

There is no evidence that inhalation exposures in occupational settings cause the rapid progressive pulmonary fibrosis and injury to the heart, liver, and kidneys that occur after ingestion. Because of the low vapor pressure, there is little inhalation hazard. Spray droplets are usually too large to reach the alveoli. If exposure is excessive, droplets may be inhaled into the upper respiratory tract and cause nosebleed, sore throat, headache, and coughing from local irritant action. Rarely, dermal exposure to paraquat has resulted in systemic poisonings and deaths with renal and pulmonary... 

Pakhale S, Moltyaner Y, Chamberlain D, Lazar N. Rapidly progressive pulmonary fibrosis in a patient treated with danazol for idiopathic thrombocytopenic purpura. Can Resp J 2004 11 55-7. 

A single low-dose exposure to mustard vapor with laryngeal and tracheobronchial mucosal effects may not lead to significant injury once healed. A cough may persist 1 month or longer. Hoarseness usually lasts only 1-2 weeks. However, repeated or chronic low-dose exposure can lead to progressive pulmonary fibrosis, chronic bronchitis, and bronchiectasis. 

Survivors of the initial poisoning or from poisonings from as little as 10-15 ml of the concentrate often develop a progressive pulmonary fibrosis associated with dyspnea and pulmonary edema several days or weeks after exposure. As a result, death is due to asphyxia. 

Bleomycin is unusual among cytotoxic drugs in that it does not cause bone marrow suppression. However, it is associated with blistering skin rashes and serious progressive pulmonary fibrosis in 10% of patients. (See Chapter 8 for use of bleomycin in the treatment of viral warts.)... 

In humans, chronic exposure to the lanthanides occurs primarily via inhalation in occupational settings. Lanthanide-induced pneumoconiosis or progressive pulmonary fibrosis has been reported in occupationally exposed workers, including photoengravers and smelter workers (Husain et al. 1980, Vocaturo et al. 1983, Sulotto et al. 1986, Haley 1991). 

IV. Diagnosis is based on a history of ingestion and the presence of gastroenteritis and oral burns. The oral mucosal burns may have the appearance of a pseudomembrane on the soft palate, sometimes confused with diphtheria. Rapidly progressive pulmonary fibrosis suggests paraquat poisoning. 

Acute pulmonary edema Diffuse alveolar hemorrhage Periengraftment respiratory distress syndrome Bronchiolitis obliterans syndrome Bronchiolitis obliterans organizing pneumonia Idiopathic pulmonary syndrome Delayed pulmonary toxicity syndrome Pulmonary cytolytic thrombi Pulmonary veno-occlusive disease Progressive pulmonary fibrosis Pulmonary hypertension Hepatopuhnonary S3mdrome Pulmonary alveolar proteinosis Eosinophilic pneumonia... 

Miyazaki Y, Araki K, Vesin C, Garcia 1, Kapanci Y, Whitsett JA, Piguet P-F, Vassalli P. Expression of a tumor necrosis fector-a transgene in murine lung causes lymphocytic andfibrosingalveohtis. A mouse model of progressive pulmonary fibrosis. J Clin Invest 1995 96 250-259. 

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