Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Alpha-1-antitrypsin deficient man presenting with lung function decline associated with dust exposure: a case report. | Zutler et al. Journal of Medical Case Reports 2011 5 154 http content 5 1 154 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Alpha-1-antitrypsin deficient man presenting with lung function decline associated with dust exposure a case report Moshe Zutler1 Patricia J Quinlan2 and Paul D Blanc3 Abstract Introduction People with arantitrypsin deficiency are at increased risk for the development of chronic obstructive pulmonary disease. Previous retrospective epidemiologic studies have found that exposure to occupational dust among those with a1-antitrypsin deficiency is a risk factor at the group level for poorer lung function but on an individual clinical basis a causal attribution can be difficult to establish. Case presentation We describe the case of a 68-year-old Caucasian man with a 25 pack-year smoking history who presented with new-onset dyspnea on exertion in the setting of workplace dust exposure. During his evaluation he was found to have arantitrypsin deficiency with evidence of development of pulmonary emphysema. Workplace spirometric monitoring over 10 years of surveillance for an on-the-job respirator fit program demonstrated a sharp downward slope in forced expiratory volume in one second or FEV1 during his periods of most significant dust exposure which was attenuated after discontinuation of his workplace exposure. Conclusion Patients with a1-antitrypsin disease should be assessed for occupational exposures and closely monitored for work-accelerated progression of lung function decline. More generally this case report supports the biological plausibility of occupationally associated chronic obstructive pulmonary disease underscoring that work-associated pulmonary disease can be multi-factorial. Introduction On a population level it is clear that occupational exposure in dusty trades are associated with the development of chronic obstructive pulmonary disease COPD in healthy individuals without other risk factors 1
