1/4. Occupational contact urticaria caused by airborne methylhexahydrophthalic anhydride.Acid anhydrides are low-molecular weight chemicals known to cause respiratory irritancy and allergy. skin allergy has on rare occasions been reported. A total of 3 subjects with occupational exposure to methylhexahydrophthalic anhydride (MHHPA) and hexahydrophthalic anhydride (HHPA) from an epoxy resin system were studied to evaluate the nature of their reported skin and nose complaints (work-related anamnesis, specific IgE, contact urticaria examinations, and ambient monitoring). Using a Pharmacia CAP system with a HHPA human serum albumin conjugate, specific IgE antibody was detected in serum from 1 (33.3%) out of the 3 workers. One unsensitized worker displayed nasal pain and rhinorrhea only when loading liquid epoxy resins into the pouring-machine (2.2 mg MHHPA/m3 and 1.2 mg HHPA/m3), probably being an irritant reaction. Two workers had work-related symptoms at relatively low levels of exposure (geometric mean 32-103 microg MHHPA/m3 and 18-59 microg HHPA/m3); one complained of only rhinitis, and the other was sensitized against HHPA and displayed both rhinitis and contact urticaria (the face and neck). The worker's skin symptoms were evidently due to airborne contact, since she had not had any skin contact with liquid epoxy resin or mixtures of MHHPA and HHPA. These urticaria symptoms were confirmed by a 20-min closed patch test for MHHPA, but not by that for HHPA. The causative agent was considered to be MHHPA, although the specific IgE determination to MHHPA was not performed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. A novel case of mealworm-induced occupational rhinitis in a school teacher.A 47-year-old African American female elementary schoolteacher presented with itchy, watery eyes, rhinorrhea, postnasal drainage, and nasal congestion complicated by recurrent epistaxis for 2 months. She had similar symptoms the previous year from September to May but was symptom free during the summer. Her symptoms began within 1 hour after entering the classroom and improved in the evening at home, on weekends, and vacation. She denied symptoms around dust, freshly cut grass, or pets and had no prior history of underlying allergic rhinitis and asthma. She had a 20-pack-a-year smoking history but quit 1 1/2 years ago. A detailed history of her classroom environment revealed the presence of mealworms that were used to teach the children about life cycles. Physical exam revealed swollen, erythematous nasal turbinates but was otherwise unremarkable. Prick skin testing was positive for oak tree, grasses, feathers, and cockroaches. Mealworm whole body extracts were prepared using standard methodology. Titration intracutaneous skin testing revealed a positive reaction at a 1:1000 concentration associated with a large delayed reaction 8 hours later that persisted for 24 hours. Specific nasal provocation using acoustic rhinometry revealed a dose response change in nasal volume (48% decrease at 1:100; 53% decrease at 1:50) and cross-sectional area (32% decrease at 1:100; 48% decrease at 1:50) in response to mealworm challenge compared with a saline control. Removal of the mealworms from the classroom resulted in complete relief of her symptoms. This is the first reported case of mealworm-induced rhinitis in a schoolteacher. Because mealworm demonstrations are now part of the standard curriculum in public school elementary classrooms in ohio, it is important that school administrators recognize the sensitizing nature of these insects and their potential for causing allergic rhinitis and asthma in the workplace.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Fungus and chronic rhinosinusitis: from bench to clinical understanding.Although fungus-related sinusitis has been described for at least 2 centuries, a more detailed pathologic description of the problem as it relates to eosinophilic disease was not detailed until 1983, when "allergic fungal sinusitis" was described histopathologically. Until then, most fungal sinus disease was perceived to occur in immunosuppressed diabetic patients with invasive fungus. It is now acknowledged that depending upon the immune status of the host, fungus-related sinus disease can take several forms. Interest in this subject matter was intensified in 1999, when it was suggested that fungi might be an important cause of most cases of chronic rhinosinusitis. This hypothesis remains controversial, and there is mounting evidence to support the multifactorial nature of chronic rhinosinusitis, which may include fungus. In fact, etiologic factors for all forms of fungus-related sinus disease are still poorly understood. The prevalence of the disease and the dominant fungal pathogen appear to vary in different geographic regions and probably are related to individual host conditions. immunoglobulin e-mediated allergic reactions to mold appear to be associated with disease in some patients, but not in all. Although antifungal therapy is known to be lifesaving for invasive disease, its role in extramucosal disease is less well defined. Preliminary trials suggest that some systemic and topical antifungal agents are of clinical benefit in extramucosal disease. Since sinus fungi are rarely invasive in immunocompetent individuals, it is not clear whether the effects of the antifungal treatments are a result of the antifungal action itself, or due to additional properties these drugs possess. This review summarizes the available data and presents some of our clinical and experimental findings as to the role of fungus in chronic rhinosinusitis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. Occupational rhinitis and asthma caused by inhalation of Balfourodendron riedelianum (Pau Marfim) wood dust.The case of a 30-year-old wood-worker, with rhinitis and asthma induced by exposure to the dust of Pau Marfim wood (Balfourodendron riedelianum) is reported. hypersensitivity to this wood was confirmed by positive skin test, bronchial challenge test and RAST. The bronchial response was inhibited by sodium cromoglycate. Unexposed persons did not exhibit reactivity to this wood in any of the tests. When electrophoretic analysis of proteins in polyacrylamide gel was applied to a crude (phosphate-buffered) extract, an homogeneous distribution of low MW material was detected, with no clearly defined bands, suggesting the presence of filamentous type proteins. To the best of the author's knowledge, this is the first reported case of occupational rhinitis and asthma due to Pau Marfim wood dust. A type I (IgE-mediated) hypersensitivity mechanism was demonstrated but the non-glomerular nature of the proteins precluded further identification of the antigens involved.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |