1/7. New occupational allergen in citrus farmers: citrus red mite (Panonychus citri).BACKGROUND: There have been several reports of occupational allergy to spider mites (tetranychidae), but no published report has described citrus red mite (CRM, Panonychus citri)-induced occupational asthma confirmed by specific bronchial challenge. OBJECTIVE: The purpose of this study was to evaluate clinical and immunologic characteristics of CRM-induced occupational asthma. methods AND RESULTS: We encountered 16 cases of CRM-induced occupational asthma among farmers cultivating citrus fruits. Asthmatic attacks corresponded closely with their work on citrus farms. The mean duration of the latent period was 12.9 (range 7 to 20) years. During their first visit to our clinic, nine patients with FEV1 lower than 70% of predictive value showed reversible airway obstruction after inhalation of bronchodilator, and seven with FEV1 greater than 70% of predictive value showed airway hyperresponsiveness to methacholine. Fifteen of the 16 also complained of recurrent nasal symptoms, which had developed at an earlier time than the asthmatic symptoms. They showed strong positive reactions to CRM extract on skin prick test (A/H ratio > or = 1.0) and had high serum specific IgE antibody against CRM which was detected by ELISA. Skin prick test with common inhalant allergens revealed that 10 had an isolated positive response to CRM with negative results to common inhalant allergens in their environment. The ELISA inhibition tests with CRM demonstrated significant inhibitions by CRM in a dose-dependent manner, while minimal inhibitions were noted by D. pteronyssinus and mugwort allergens. CONCLUSION: These findings suggest that CRM could induce IgE-mediated bronchoconstriction in exposed workers on citrus farm.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/7. Occupational IgE-mediated allergy to tribolium confusum (confused flour beetle).BACKGROUND: We report on IgE-mediated allergy in a worker caused by tribolium confusum (confused flour beetle). These beetles lived in the "old" flour to which he was exposed in his work. CASE REPORT: A 35-year-old, nonatopic mechanic in a rye crispbread factory developed rhinitis, conjunctivitis, and asthmatic symptoms, as well as urticaria on his wrists, lower arms, hands, neck, and face, during the maintenance and repair of machines contaminated by flour. This flour had been in and on the machines for a long time, and it contained small beetles. The patient did not suffer any symptoms when handling fresh, clean flour. RESULTS: Skin prick tests with standard environmental allergens, storage mites, enzymes, flours, and molds were negative. A prick test with flour from the machines gave a 10-mm reaction. An open application of the same flour caused urticarial whealing on the exposed skin. Prick tests with fresh flour from the factory were negative. A prick test with minced T. confusum from the flour in the machines gave a 7-mm reaction. histamine hydrochloride 10 mg/ml gave a 7-mm reaction. Specific serum IgE antibodies to T. confusum were elevated at 17.2 kU/l. Prick tests with the flour from the machines were negative in five control patients. CONCLUSIONS: The patient had occupational contact urticaria, rhinitis, conjunctivitis, and asthmatic symptoms from exposure to flour. His symptoms were caused by immediate allergy to the beetle T. confusum. Immediate allergy to this beetle has rarely been reported in connection with respiratory symptoms, but it may be more common. Contact urticaria from this source has not been reported before.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/7. Allergic vulvovaginitis in infancy: study of a case.BACKGROUND: the role of dust mites (Dermatophagoides pt.) in the pathogenesis of allergic vulvovaginitis is still controversial. association between this mite and atopic dermatitis, conjunctivitis, rhinitis or asthma is already known.Some authors study the possible relationship between some vulvovaginitis and local hypersensitivity. The aim of this study was to corroborate the allergic aetiology due to the mite Dermatophagoides pt. in a girl with vulvovaginitis and perennial rhinitis. methods AND RESULTS: we studied a nine year-old patient with symptoms of perennial rhinitis and unspecific vulvovaginitis of torpid evolution. In vivo and in vitro allergologic tests were performed as well as complete analytic tests including immunoglobulins, urine tests, nasal culture, exudative vaginal culture, and parasitic test.Skin test was positive for Dermatophagoides pt. as well as specific IgE (99.5 kU/L). Total IgE was elevated for her age (492 kU/L). In the rest of the complementary tests, no values out of normality or pathological findings were obtained. CONCLUSIONS: considering these results, it was suspected that the nasal symptoms and the vulvovaginitis presented by the patient are of allergic aetiology by hypersensitivity to the mite Dermatophagoides pt. The study did not prove relation with bacteria, parasites, candida albicans or any inhalant allergens other than mites.After three months of treatment with oral antihistamines and topical chromones, as well as environmental avoiding measures, the symptoms totally yielded.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/7. Dentist's occupational asthma, rhinoconjunctivitis, and allergic contact dermatitis from methacrylates.BACKGROUND: Allergic contact dermatitis (ACD) caused by (meth)acrylates (MA) is common in dental personnel. MAs have also caused asthma and rhinoconjunctivitis, but asthma, rhinoconjunctivitis and ACD caused by MAs in the same patient appears to be very rare. methods: Occupational asthma and rhinoconjunctivitis were diagnosed in a dentist according to patient history, PEF monitoring, and a work-simulated bronchial provocation test. ACD was diagnosed by skin-patch testing with MAs with the occlusive Finn Chamber-technique. RESULTS: The patient's skin-prick test reactions to common environmental allergens and MAs were negative. The total IgE was not elevated. Occupational asthma was diagnosed by a specific inhalation challenge test in which the patient handled liquid dental MAs for 30 min causing a delayed 23% reduction in FEV1. The provocation test also resulted in rhinoconjunctivitis. On patch testing, positive reactions were provoked by several MAs including 2-hydroxyethyl methacrylate (2-HEMA) to which the patient was occupationally exposed. The patient has not been able to continue her work with dental MAs. CONCLUSIONS: A case of occupational asthma, rhinoconjunctivitis and ACD caused by dental acrylate compounds is presented. patients with respiratory hypersensitivity from MAs have to stop working with MAs, whereas patients with ACD from MAs need to avoid direct contact with MAs, but can often continue in their present job if they use no-touch techniques.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/7. Buckwheat pillow-induced asthma and allergic rhinitis.BACKGROUND: Immunoglobulin (Ig)E-mediated hypersensitivity is a mechanism suggested to explain adverse reactions to buckwheat. This is the first reported case in the united states of a person who developed asthma and worsening allergic rhinitis after exposure to a buckwheat pillow. OBJECTIVE: To describe a patient who developed asthma and worsening allergic rhinitis after exposure to a buckwheat pillow and to provide evidence that the adverse reaction was IgE-mediated. methods: The patient underwent skin prick and ImmunoCAP testing (Pharmacia Diagnostics, Kalamazoo, MI) to buckwheat as well as skin prick testing to several environmental allergens. RESULTS: The patient showed a 4 skin prick test response to buckwheat. He also showed 4 positive skin prick responses to multiple trees, grasses, and weeds, alternaria, helminthosporium, dog, and histamine control and was 3 positive to house-dust mites, penicillium, aspergillus, cat, and feather mix. His negative control was negative. His ImmunoCAP test for buckwheat-specific IgE was class 4, or strongly positive. He had normal spirometry values. Performance of house-dust mite avoidance measures did not result in improvement of the patient's symptoms. Removal of the patient's two buckwheat pillows resulted in resolution of his asthma and improvement of rhinitis symptoms. CONCLUSIONS: The positive skin prick and ImmunoCAP test to buckwheat along with the positive clinical response to buckwheat pillow elimination support an IgE-mediated mechanism in explaining our patient's buckwheat pillow-induced asthma and allergic rhinitis.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/7. The role and allergenic importance of storage mites in house dust and other environments.skin tests were performed on 210 patients with house dust allergy and bronchial asthma or perennial rhinitis using extracts of dermatophagoides pteronyssinus and of four storage mites most commonly found in house dust in the United Kingdom--Acarus siro, Tyrophagus putrescentiae, Lepidoglyphus (formerly Glycyphagus) destructor and Glycyphagus domesticus. The results of the skin tests were related to certain occupations and living conditions of the patients which could have exposed them to storage mites and some patients were included because their environment seemed especially likely to expose them to these species in order to assess the importance of these conditions. D. pteronyssinus was the most potent of the mite allergens and provoked the largest number of positive tests but a proportion of the storage mite species gave skin reactions which were larger or as large as those of D. pteronyssinus. No significant statistical correlation was found between reactions to D. pteronyssinus and any storage mite but highly significant correlations were found between some storage species. The frequency and strength of reactions to these species were unexpectedly high in view of their irregular occurrence and relative scarcity in house dust. It is suggested that sensitisation to these species occurs through exposure either to localised sources of infestation overlook during the random collection of floor or bedding dust or to infested materials encountered at work or other activities or to infested food or bedding of certain domestic pets. It is concluded that allergy to storage mites is more important and widespread that hitherto realised and is a considerable occupational hazard in farming communities and to those in occupations handling infested materials. Storage mites may also be important allergens for those living in very damp houses where the growth of moulds may encourage the development of Glycyphagus domesticus or other mites.- - - - - - - - - - ranking = 5keywords = environment (Clic here for more details about this article) |
7/7. Nasal peak-flow-rate recording is useful in detecting allergic nasal reactions--a case report.Serial nasal peak-expiratory-flow-rate recordings have been used to detect changes in nasal patency. A hospital nurse with allergy to latex showed a marked decrease in nasal flow when exposed to latex gloves in a challenge test and in her work environment. We propose using the method as a diagnostic tool for allergic rhinitis in occupational and other exposure situations in which nasal blockage is a prominent symptom.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |