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Recurrence of acute respiratory failure following use of waterproofing sprays
  1. R Heinzer1,
  2. V Ribordy2,
  3. B Kuzoe3,
  4. R Lazor4,
  5. J W Fitting1
  1. 1Service de pneumologie, CHUV, Lausanne, Switzerland
  2. 2Centre interdisciplinaire des urgences, CHUV, Lausanne, Switzerland
  3. 3Hôpital du Samaritain, Vevey, Switzerland
  4. 4Service de pneumologie, HUG, Geneve, Switzerland
  1. Correspondence to:
    Dr R Heinzer
    c/o Beth Israel Deaconess Hospital, 330 Brookline Avenue, Stoneman 8, Boston, MA 02215, USA; rheinzerrics.bwh.harvard.edu

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Between January and March 2003 six patients were admitted to hospital in the Lausanne area of Switzerland with acute respiratory failure following use of a waterproofing spray for clothes and leather. Within hours of exposure all patients developed a dry cough and rapidly progressive dyspnoea. The clinical picture included severe hypoxaemia, increased white blood cell count, raised C-reactive protein, and reduced carbon monoxide transfer factor (Tlco). All patients had diffuse bilateral ground glass opacities on a high resolution CT scan, most often sparing the subpleural areas (fig 1). Every patient improved following treatment with oral prednisone (0.5–0.9 mg/kg) but residual dyspnoea and reduced Tlco (<80% of predicted value) could be seen for more than 2 weeks.

Acute respiratory failure was attributed to inhalation of the waterproofing spray in view of …

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