Interstitial lung disease and domestic wood burning

A 61-yr-old woman was evaluated for dyspnea on exertion and interstitial lung disease. A unique association between inhaled particulates from wood burning and interstitial pneumonitis was demonstrated. Bronchoalveolar lavage revealed numerous particulates and fibers, as well as cellular and immunoglobulin abnormalities. The particles were shown to be carbonaceous by energy dispersive X-ray analysis (EDXA). Inflammation and fibrosis were found surrounding them on open biopsy. The particle source was traced to a malfunctioning wood-burning heater in the patient's home. We present this case to highlight the usefulness of BAL and EDXA in the elucidation of particle-associated lung disease.