[Bronchial irritation syndrome following inhalation or urea. Histologic and immunohistochemical evaluation]

We herein report the case of a subject exposed to urea fumes. After exposure, the subject immediately experienced throat and chest burning. A few hours later, she had cough, dyspnea and wheezing during exercise. The functional pulmonary testing performed two months later showed non-specific airway responsiveness. Bronchoscopy with broncho-alveolar lavage and bronchial biopsies was performed. Biopsies showed injury of the epithelial layer that was atrophic and devoid of ciliated cells. There was fibrosis of connective tissue as well as an inflammatory infiltrate. Immunohistochemistry stains showed that most of the inflammatory cells were T-lymphocytes. There were no degranulated eosinophils. The subject was given inhaled steroids. Four months later, bronchial responsiveness was normal.