SESSION TITLE: Obstructive Airway Disease Cases
SESSION TYPE: Affiliate Case Report Slide
PRESENTED ON: Sunday, October 26, 2014 at 03:15 PM - 04:15 PM
INTRODUCTION: Freon 12B2 is widely used as a refrigerant, solvent and in aerosol applications. Accidental or intentional inhalation of Freon can lead to severe adverse outcomes in humans like transient confusion, cardiac arrhythmia and asphyxia. We report a rare case of reactive airway dysfunction syndrome secondary to Freon inhalation.
CASE PRESENTATION: A 60-year-old male with a past medical history of diabetes, morbid obesity, Obstructive sleep apnea was referred to pulmonary clinic for evaluation of shortness of breath. He was a never smoker and he has no prior history of lung disease. About 7days ago, while performing repairs beneath a school bus, he was exposed to an air-conditioner refrigerant spill. It took him nearly one minute to get out of the car.Afterwards, he experienced worsening shortness of breath with minimal exertion, productive cough and wheezing. His oxygen saturation in the clinic was noted to be 82% on room air and 90% on 3L of nasal cannula oxygen. He was admitted to the hospital for further work up. Spirometry showed airflow obstruction with FEV1 1.97L (45%).Respiratory status improved with bronchodilators and oral steroids.Repeat spirometry after 2 weeks showed some improvement in obstruction with FEV1 2.5L(60%).Six months after the incident,his symptoms improved with but he was still having shortness of breath on exertion and occasional cough.
DISCUSSION: Freon is usually absorbed from the airway and cause bronchospasm, asphyxia and hypoxia which are transient. However, reactive airway dysfunction syndrome after exposure from its irritant effects on airway can occur and may continue for months or years.patient can experience prolong symptms for months to few years like caused by any other agent.Patients typically respond well with standard therapy with steroids and bronchodilators.
CONCLUSIONS: Freon 12B2 exposure can lead to reactive airway dysfunction syndrome. Symptoms may last for prolong periods.
Reference #1: JL Malo et al."Occupational asthma due to heated freona".Thorax 1984;39:628-629
Reference #2: John Marx, et al. “Hydrocarbons” from Rosen's Emergency Medicine, Eighth Edition. Chapter 158, 2032-2035.e1
Reference #3: Piirila P, et al. “Prolonged respiratory symptoms caused by thermal degradation products of freons.” Scand J Work Environ Health. 2003 Feb;29(1):71-7
DISCLOSURE: The following authors have nothing to disclose: Viral Doshi, Nang Kham, Shreedhar Kulkarni, Kent Kapitan
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