RESUMO
Following acute exposure to chlorine gas, 18 asymptomatic subjects were evaluated for early pulmonary dysfunction. Airway obstruction was evident in all exposed individuals immediately after chlorine exposure. The severity, course of the obstructive defect, and clinical picture correlated with the chief complaint on admission. The obstructive abnormalities resolved within 1 wk after exposure to chlorine in 12 subjects whose chief complaint was cough. A slower resolution of the physiologic changes, clinical signs, and symptoms was noted in 6 subjects whose initial chief complaint was dyspnea. In this group, maximum mid-expiratory flow rate (FEF25-75%), and forced expiratory flow after exhaling 50% and 75% of the vital capacity (FEF50% and FEF25%, respectively) were still diminished 2 wk after chlorine exposure. The slow rate of resolution in the dyspnea group is best explained by increased individual susceptibility since a past medical history of smoking or asthma and "wheezing" was more prevalent in this group.
Assuntos
Obstrução das Vias Respiratórias/induzido quimicamente , Cloro/intoxicação , Adulto , Alcalose Respiratória/induzido quimicamente , Dispneia/induzido quimicamente , Feminino , Fluxo Expiratório Forçado , Humanos , Pulmão/efeitos dos fármacos , Pulmão/fisiopatologia , Masculino , Fluxo Máximo Médio Expiratório , Pessoa de Meia-Idade , Ventilação Pulmonar/efeitos dos fármacos , Capacidade Vital/efeitos dos fármacosRESUMO
A middle-aged man developed multiple subcutaneous rheumatoid granulomata, high titer of rheumatoid factor, diffuse interstitial pulmonary fibrosis and digital clubbing in the absence of clinicoradiological evidence of synovial disease. This patient supports the concept of rheumatoid disease without arthritis.