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Respiratory Disease and Fiberglass Exposure: Report of a Case and Review of the Literature

Vahid, Bobbak MD; Awsare, Bharat MD; Marik, Paul E. MD

doi: 10.1097/CPM.0b013e3181514c6e
Topics in Pulmonary Medicine
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This report describes a 23-year-old man with exposure to fiberglass who presented with dry cough of 4 months duration. Computed tomography of the chest showed mediastinal lymph node enlargement and pulmonary infiltrates. Lymph node biopsy showed granulomatous lymphadenitis with giant cell formation. The mediastinal lymphadenopathy and the pulmonary infiltrates resolved after cessation of fiberglass exposure. The effects of fiberglass exposure on the respiratory system have been evaluated in several epidemiologic studies. Although fiberglass is widely used and low levels of exposure are commonplace, these studies have not shown a significant increase in mortality from respiratory malignancies or nonmalignant respiratory diseases in individuals with fiberglass exposure. The commonly reported abnormal findings on chest radiographs are low profusion micronodular opacities, hilar enlargement, and pleural thickening. Rare cases of pulmonary fibrosis, acute eosinophilic pneumonia, and sarcoidosis-like pulmonary disease have been described after exposure to fiberglass. Detailed exposure history is essential to make the diagnosis. Cessation of fiberglass exposure is important in management of these patients. Inhalation fever, reactive airway disease, and chemical pneumonitis also can be the result of exposure to an endotoxin or binder agents.

This report describes a 23-year-old man with sarcoidosis-like pulmonary granulomatosis as a result of fiberglass exposure. The commonly reported abnormal findings on chest radiographs in individuals exposed to fiberglass are low-profusion micronodular opacities, hilar enlargement, and pleural thickening. Rare cases of pulmonary fibrosis, acute eosinophilic pneumonia, and sarcoidosis-like pulmonary disease have been described after exposure to fiberglass. The subject of fiberglass exposure and respiratory disease is reviewed.

From the Department of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.

Address correspondence to: Bobbak Vahid, MD, 834 Walnut Street Suite 650, Philadelphia, PA 19107. E-mail: bobbak.vahid@mail.tju.edu.

© 2007 Lippincott Williams & Wilkins, Inc.