Trimellitic Anhydride
Exposure
- Manufacture of Paints/Epxoy Resins/Plastics: commonly occurs following spraying of trimellitic anhydride onto a hot surface -> generates fumes
Physiology
- Trimellitic Anhydride Fume or Dry Powder Inhalation
- Mechanism: probable immunologic reaction for alveolar hemorrhage
Clinical Presentations
- Occupational Asthma (see Asthma-Occupational, [[Asthma-Occupational]])
- Diffuse Alveolar Hemorrhage (see Diffuse Alveolar Hemorrhage, [[Diffuse Alveolar Hemorrhage]])
- Epidemiology
- Latency Period: 1-3 months after exposure
- Diagnosis
- CXR/Chest CT Patterns: diffuse or patchy focal alveolar infiltrates
- Interstitial infiltrates may appear with chronic or recurrent disease
- Anitbodies to trimellitic anhydride: may be present
- CBC: leukocytosis, anemia (iron deficiency if bleeding is severe or recurrent)
- ESR: elevated
- Urinalysis: usually normal
- PFT’s: increased DLCO (during alveolar hemorrhage)
- OLB: absence of Pulmonary Capillaritis: bland alveolar hemorrhage
- Clinical
- Cough
- Dyspnea
- Hemoptysis: may be absent on initial presentation in some cases (even after significant bleed)
- Chest Pain: may occur
- Absence of renal or other systemic involvement
- Interstitial Lung Disease (see ILD-Etiology, [[ILD-Etiology]]): may occur with recurrent diffuse alveolar hemorrhage
Treatment
- Avoid Exposure: symptoms usually resolve without sequelae
References