An Autopsy Case of An Acute Exacerbation of Idiopathic Pulmonary Fibrosis Triggered by the Inhalation of a Waterproofing Spray

Takako Kawaguchi; Takashi Tachiwada; Kei Yamasaki; Kei Nakamura; Eisuke Katafuchi; Masahiro Tahara; Yu Isoshima; Hidenori Ohira; Hiroki Kawabata; Kanako Hara; Kazuhiro Yatera

doi:10.2169/internalmedicine.8330-21

CASE REPORTS

An Autopsy Case of An Acute Exacerbation of Idiopathic Pulmonary Fibrosis Triggered by the Inhalation of a Waterproofing Spray

Takako Kawaguchi, Takashi Tachiwada, Kei Yamasaki, Kei Nakamura, Eisuke Katafuchi, Masahiro Tahara, Yu Isoshima, Hidenori Ohira, Hiroki Kawabata, Kanako Hara, Kazuhiro Yatera

Author information

Takako Kawaguchi
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Takashi Tachiwada
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kei Yamasaki
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kei Nakamura
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Eisuke Katafuchi
Department of Pathology, University of Occupational and Environmental Health, Japan
Masahiro Tahara
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Yu Isoshima
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Hidenori Ohira
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Hiroki Kawabata
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kanako Hara
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kazuhiro Yatera
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan

Keywords: autopsy, acute exacerbation, diffuse alveolar damage, idiopathic pulmonary fibrosis, interstitial lung disease, waterproofing spray

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 12 Pages 1881-1886

DOI https://doi.org/10.2169/internalmedicine.8330-21

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Abstract

An 82-year-old Japanese man with idiopathic pulmonary fibrosis (IPF) experienced dyspnea after using a waterproofing spray in a closed room. He presented with hypoxemia and his chest computed tomography showed additive bilateral diffuse ground-glass attenuation on fibrosis, which was diagnostic of an acute exacerbation of IPF (AE-IPF). Combined treatment with high-dose corticosteroids and immunosuppressants were ineffective, and he later died of respiratory failure. Autopsy findings showed diffuse alveolar damage with honeycombing. His medical history and autopsy histopathology suggested AE-IPF caused by the inhalation of a waterproofing spray.

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