Cobalt related interstitial lung disease.
Cobalt exposure in the hard metal and bonded diamond tool industry is a well-established cause of ILD. The primary theories regarding the underlying mechanism of cobalt related ILD include an immunologic mechanism and an oxidant injury mechanism. Cobalt related ILD may present in subacute and chronic forms and often has associated upper respiratory symptoms. The evaluation begins with a thorough occupational history and includes PFTs, HRCT, and bronchoalveolar lavage. HRCT findings are nonspecific and may resemble NSIP, UIP, sarcoidosis, or HP. The finding of cannibalistic multinucleated giant cells is diagnostic provided there is a history of exposure and appropriate changes on imaging; however, when these cells are not found on lavage, lung biopsy is required for diagnosis. Giant cell interstitial pneumonia is the classic pathologic pattern, but cobalt related ILD may also present with pathologic findings of UIP, DIP, or HP. When cobalt related ILD is suspected, removal from exposure is the most important step in treatment. Case reports suggest that treatment with steroids results in symptomatic, physiologic, and radiographic improvement.
['Adams|Traci N|TN|', 'Butt|Yasmeen M|YM|', 'Batra|Kiran|K|', 'Glazer|Craig S|CS|']
D000497:Alloys D018893:Bronchoalveolar Lavage D003035:Cobalt D015726:Giant Cells D006801:Humans D019570:Inhalation Exposure D017563:Lung Diseases, Interstitial D016273:Occupational Exposure D012129:Respiratory Function Tests D014057:Tomography, X-Ray Computed D016896:Treatment Outcome D014414:Tungsten
Interstitial lung disease Cobalt related ILD Hard metal lung disease