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1/6. urticaria and rhinitis to shrubs of ficus benjamina and breadfruit in a banana-allergic road worker: evidence for a cross-sensitization between Moracea, banana and latex.

    BACKGROUND: We report the case of a road worker with a food allergy to banana, who developed urticaria and rhinitis when cutting shrubs of ficus benjamina and breadfruit. He did not develop an allergy to latex of hevea brasiliensis. RESULTS: Sensitization to latex of F. benjamina, H. brasiliensis, breadfruit and banana was demonstrated using skin tests and specific IgE measurements. RAST inhibitions procedures showed that specific IgE to breadfruit latex cross-reacted more strongly with latex of H. brasiliensis and banana than with latex of F. benjamina with the same extract. CONCLUSION: Given the wide distribution of Moracea trees in tropical regions, sensitization to latex of H. brasiliensis and banana could be a consequence of sensitization to Moracea members; F. benjamina does not seem to be the only Moracea responsible for cross-allergy with latex and fruit. Consequently, it seems interesting to test other members of the Moracea family in patients sensitized to latex of H. brasiliensis and banana. Sensitization to breadfruit could be a risk factor for sensitization to latex of H. brasiliensis.
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2/6. 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.
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3/6. Cross-reactivity between obeche wood (Triplochiton scleroxylon) and natural rubber latex.

    BACKGROUND: Several studies have shown that allergy to natural rubber latex is associated with cross reactivity to other plants. We have investigated a possible cross reactivity with a tree belonging to the sterculiaceae family, Tryplochiton scleroxylon, in a patient allergic to obeche wood, that began to suffer symptoms of allergy in contact with latex. methods: Determinations of specific IgE by CAP to obeche, natural rubber latex (NRL) and recombinant allergens of latex were done. immunoblotting was performed to study allergens detected by serum of our patient. CAP-inhibition methods were used to study cross-reactive between NRL and obeche wood. RESULTS: In obeche extract, 4 bands were found of an apparent molecular weight of 18, 38, 75 and 199 kDa. In NRL extract the allergens have a molecular weight around 18, 21, 32, 38, 60, 70 and 199 kDa. IgE to latex was almost completely inhibited (96%) by the obeche extract in CAP-inhibition studies. Using obeche extract as inhibitor, IgE binding to native hevein (nHevb 6.02) was reduced by 25%. CONCLUSIONS: The results obtained in CAP-inhibition demonstrate the existence of cross-reactivity between proteins in NRL and obeche wood. In our patient, a band of apparent molecular weight of 38 kDa could be the most important allergen.
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4/6. Contact urticaria and rhinitis from latex surgical gloves.

    latex used in the manufacture of surgical gloves should be included in a list of allergens. It is found in the tree hevea braziliensis. For approximately the last year, minutes after using surgical gloves, a female doctor had severe pruritus followed by a rash and angio-oedema of the contact areas. During the last 4 months, on opening the glove-bag, she experienced severe rhinitis and respiratory distress. The symptoms ceased in 1 h. Standard patch tests and with substances used in the manufacture of rubber were negative. Prick tests with glove and natural latex were strongly positive. The presence of specific IgE against natural latex was demonstrated by means of a histamine release assay as well as by immunoenzymatic methods. The antigen seems to have a MW higher than 30,000 d and is trypsin-sensitive. These facts suggest that the allergen could be a protein present in the "crude natural latex".
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5/6. Occupational rhinoconjunctivitis and bronchial asthma due to Phoenix canariensis pollen allergy.

    We report a case of occupational bronchial asthma and rhinoconjunctivitis caused by Phoenix canariensis (PC) pollen. The canary palm is a type of palm tree, belonging to the arecaceae family, which is widely distributed in frost-free regions as an ornamental tree. Our patient was referred because he suffered symptoms of bronchial asthma, rhinoconjunctivitis, and contact urticaria when pruning dried leaves from PC during the pollination months. The skin prick test (SPT) with a PC pollen extract was positive, as was the specific IgE to PC pollen determined by Phadezym RAST, indicating an IgE-mediated sensitization. The nonspecific bronchial provocation test (BPT) performed with methacholine disclosed a mild bronchial hyperreactivity, and specific BPT with PC pollen elicited an immediate fall of 25% in FEV1 with respect to baseline. On RAST inhibition studies, a significant cross-reactivity was found between PC pollen and date palm (P. dactylifera) pollen. These results suggest that PC pollen could be a potential allergen in PC-growing areas.
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6/6. Allergy to the ornamental indoor green plant tradescantia (Albifloxia).

    We report on a 32-year-old atopic female office employee with a moderate tree pollinosis who also suffered from indoor-related perennial rhinoconjunctivitis. Once when she repotted her two ornamental nonflowering green plants of the genus tradescantia (synonym; Albifloxia; family commelinaceae), she immediately experienced itching of the face, throat, and conjunctiva; swelling of the lips; and dyspnea and wheezing. Skin prick tests with the leaves of tradescantia (T. albifloxia and T. fluminensis) (Ta and Tf) were strongly positive as was the specific IgE to Ta leaves extract. On RAST inhibition studies, no cross-reactivity was found between Ta and ficus benjamina (weeping fig), a nonflowering green plant, which produces, in its milky sap, an important respiratory allergen. Green plants should be considered potential indoor allergens and tested in plant-keepers referred for allergologic investigation.
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