Chest
Volume 105, Issue 6, June 1994, Pages 1895-1896
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Selected Reports
Persistent Asthma After Inhalation of a Mixture of Sodium Hypochlorite and Hydrochloric Acid

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Chlorine gas inhalation can lead to temporary mucous membrane irritation, pulmonary edema, and transient bronchospasm. Existence of respiratory sequelae is debated. We report a case of asthma, persisting 2 years after the inhalation of a mixture of sodium hypochlorite and hydrochloric acid. Bronchial histologic findings and transmission electron microscopy examinations showed uncommon abnormalities supporting irritation for cause of this nonimmunologic asthma.

Section snippets

CASE REPORT

We report the case of a 39-year-old nonsmoking woman with atopy who developed persistent asthma after inhalation, for 5 min, of emanations of an untoward mixture of sodium hypochlorite and hydrochloric acid.

This patient had no preexisting respiratory complaint, but her mother suffered from allergic rhinitis owing to dust and her sister was asthmatic. She presented for 2 days with cough and wheezing, regressive with salbutamol injections. A chest x-ray film during the initial evaluation was

DISCUSSION

As far as we know, this is the first case published of asthma that persisted years after inhalation of a mixture of sodium hypochlorite and hydrochloric acid, a common domestic accident.

Subepithelial fibrosis commonly is observed in asthma.3 However, the lack of eosinophils is unusual4 and surprising, since the patient was atopic. The onset of asthma after the accident and the histologic abnormalities support irritation and caustic injuries (and not inflammation) as a primary hypothesis for

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