Interstitial pneumonitis after acetylene welding: a case report

Int J Occup Med Environ Health. 2014 Jan;27(1):132-6. doi: 10.2478/s13382-014-0235-2. Epub 2014 Mar 22.

Abstract

Acetylene is a colorless gas commonly used for welding. It acts mainly as a simple asphyxiant. In this paper, however, we present a patient who developed a severe interstitial pneumonitis after acetylene exposure during aluminum welding. A 44-year old man was welding with acetylene, argon and aluminum electrode sticks in a non-ventilated aluminum tank for 2 h. Four hours after welding dyspnea appeared and 22 h later he was admitted at the Emergency Department due to severe respiratory insufficiency with pO2 = 6.7 kPa. Chest X-ray showed diffuse interstitial infiltration. Pulmonary function and gas diffusion tests revealed a severe restriction (55% of predictive volume) and impaired diffusion capacity (47% of predicted capacity). Toxic interstitial pneumonitis was diagnosed and high-dose systemic corticosteroid methylprednisolone and inhalatory corticosteroid fluticasone therapy was started. Computed Tomography (CT) of the lungs showed a diffuse patchy ground-glass opacity with no signs of small airway disease associated with interstitial pneumonitis. Corticosteroid therapy was continued for the next 8 weeks gradually reducing the doses. The patient's follow-up did not show any deterioration of respiratory function. In conclusion, acetylene welding might result in severe toxic interstitial pneumonitis that improves after an early systemic and inhalatory corticosteroid therapy.

Publication types

  • Case Reports

MeSH terms

  • Acetylene / toxicity*
  • Adult
  • Androstadienes / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Bronchodilator Agents / therapeutic use
  • Fluticasone
  • Gases / toxicity*
  • Humans
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / etiology*
  • Male
  • Methylprednisolone / therapeutic use
  • Occupational Diseases / diagnosis
  • Occupational Diseases / drug therapy
  • Occupational Diseases / etiology*
  • Occupational Exposure / adverse effects*
  • Welding*

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Bronchodilator Agents
  • Gases
  • Fluticasone
  • Acetylene
  • Methylprednisolone