A systemic review on clinical characteristics, diagnosis and treatment of hard metal lung disease
10.3760/cma.j.cn121094-20240530-00245
- VernacularTitle:硬金属肺病临床特征与诊治的系统性综述
- Author:
Xuqin DU
1
;
Na WU
1
;
Jing MA
1
;
Qiao YE
1
Author Information
1. 首都医科大学附属北京朝阳医院职业病与中毒医学科，北京市呼吸疾病研究所，间质性肺疾病临床诊疗与研究中心，北京 100020
- Publication Type:Journal Article
- Keywords:
Lung diseases;
Hard metal lung disease;
Cobalt;
Tungsten carbide;
Giant cell interstitial pneumonia;
Clinical feature
- From:
Chinese Journal of Industrial Hygiene and Occupational Diseases
2025;43(10):735-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics, treatment and prognosis of hard metal lung disease (HMLD), and to provide a theoretical reference basis for the prevention, control and intervention of HMLD in China.Methods:In April 2024, literatures related to HMLD and giant cell interstitial pneumonia (GIP) published before March 31, 2024 were retrieved in China National Knowledge Infrastructure (CNKI), Wanfang, VIP database, Embase and PubMed. The search terms in Chinese and English included hard metal lung disease, cobalt, tungsten carbide, giant cell interstitial pneumonia, hard metal, etc. Literature was screened and data were extracted. A systematic review was conducted to analyze the clinical characteristics, imaging, pulmonary function, pathological features, treatment and prognosis of HMLD.Results:A total of 55 literatures were included, including 1 cohort study, 4 cross-sectional studies, 4 case series reports and 46 case reports, involving a total of 227 patients with HMLD and GIP. There were 174 male cases, 51 female cases, and 2 cases whose gender was not mentioned. The age was (43.9±13.4) years old, and the dust exposure time was 7 (4, 13) years. The chest images of the patients showed ground glass shadow, micro-nodule shadow, grid shadow, honeycomb shadow, consolidation shadow, etc. Pulmonary function test showed restrictive ventilation dysfunction with gas exchange disorder. The pathological manifestations of lung tissue were typical GIP, but there were also hypersensitivity pneumonitis, common interstitial pneumonia, diffuse alveolar damage, non-specific interstitial pneumonia, and even honeycomb lung. Clinical diagnosis and treatment evaluation were performed by combining the occupational exposure history of hard metal dust or cobalt-containing dust, clinical manifestations, imaging, lung function and histopathology. Treatment involved cessation of exposure, with glucocorticoids alleviating symptoms and improving imaging and pulmonary function.Conclusion:HMLD can be caused by hard metal dust exposure. The clinical symptoms of HMLD are not specific, and the pathology shows typical GIP or other pulmonary interstitial changes. The treatment involves cessation of exposure and administration of glucocorticoids, and the overall prognosis is good.
