Late Pulmonary Complication of Mustard Gas Inhalation
By Mastafa Ghanei, MD Associate Professor Dept. of Internal Medicine Baghiatallah University of Medical Sciences Mollasadra Ave., Tehran, Iran
Thousands of Iranian people were injured by mustard gas in the Iraq war [e.g., the 1981-1988 Iran-Iraq War]. This injury results in chronic disabilities of eyes, lung and skin organs.
Chronic cough, dyspnea [shortness of breath] and hemoptysis [coughing up of blood or blood-stained sputum] were the major presenting symptoms in these patients.
We studied late pulmonary complications of these patients. One hundred mustard gas victims were selected through a cross sectional study. All selected had documented criteria, pulmonary function tests, high resolution chest CT scan, bronchioscopy and routine blood tests, which were done in a well equipped center.
All patients had chronic bronchitis in their bronchial biopsy.
Pulmonary fibroses, with different types of histology [microscopic tissue structure], were detected in 80% of patients.
A cytologic [cellular] study of bronchial lavage [removal of secretion, cells, and proteins from the lungs using sterile fluid] did not show neoplastic [tumor] cells.
HRCT [e.g., High Resolution CT Scan] findings were compatible with bronchial [upper airway] thickening and subpleural fibrosis [abnormal thickening of the outer membrane of the lung] with definite correlation with histologic [microscopic cellular] data in all patients.
Late complications of mustard gas includes bronchial [upper airway] and paranchymnal [bulk of the lung] involvement.
Although the causative agent is not [any longer] present, the disease has a continuous nature and sometimes progressive course, with end-stage lung disease the outcome.
[End-Stage lung disease: The final stages of lung disease, when the lung can no longer keep the blood supplied with oxygen. End-stage lungs in pulmonary fibrosis have large air spaces separated by bands of inflammation and scarring.]