CHRONIC LUNG INFLAMMATION IN VICTIMS OF TOXIC GAS LEAK AT BHOPAL

Citation
Vk. Vijayan et al., CHRONIC LUNG INFLAMMATION IN VICTIMS OF TOXIC GAS LEAK AT BHOPAL, Respiratory medicine, 89(2), 1995, pp. 105-111
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System","Respiratory System
Journal title
ISSN journal
0954-6111
Volume
89
Issue
2
Year of publication
1995
Pages
105 - 111
Database
ISI
SICI code
0954-6111(1995)89:2<105:CLIIVO>2.0.ZU;2-P
Abstract
Bronchoalveolar lavage (BAL) studies in 20 patients at Bhopal, 1.3 +/- 0.4 yr and 27 rt 0.6 yr after toxic gas exposure had revealed that th e lower respiratory tract inflammation had progressed from initial mac rophage alveolitis to macrophage-neutrophilic alveolitis. The interval between the two lavages was 1.4 +/- 0.6 yr. BAL studies in a new grou p of 24 patients 5.1 +/- 1.0 yr after exposure had confirmed chronic i nflammation of the lower respiratory tract as evidenced by macrophage- neutrophilic alveolitis in these subjects as well. Clinical, radiograp hic and pulmonary function abnormalities were persistent in a proporti on of subjects in both groups. Fibronectin (FN) levels were estimated in BAL fluid in 41 patients. Elevated FN levels were seen in 12 (29.3% ) subjects and nine of these 12 had radiographic abnormalities. Severe ly exposed subjects (n = 30) had significantly higher BAL fibronectin levels compared to normal subjects and mild/moderately exposed subject s. Repeat FN estimations in BAL samples from 10 patients had revealed that five had abnormally high FN including three who had high FN on bo th occasions. The number of patients showing abnormal decline in pulmo nary function was higher in patients with elevated FN than in patients with normal FN. Thus, persisting clinical, roentgenographic and venti latory abnormalities, as well as macrophage-neutrophilic alveolitis al ong with abnormally elevated FN levels in a proportion of subjects, su ggest the possibility that lung fibrosis can occur in subjects exposed to toxic gas at Bhopal.