1/3. 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 = tree (Clic here for more details about this article) |
2/3. Occupational wood-dust sensitivity from euonymus europaeus (spindle tree) and investigation of cross reactivity between E.e. wood and artemisia vulgaris pollen (mugwort).A 44-year-old goldsmith suffered from rhinitis and conjunctivitis after having worked with wood dust from euonymus europaeus (E.e.) for 15 years. The material was used for drying pieces of jewelry. Very strong reactions could be seen after friction test, scratch test and nasal challenge using wood dust of E.e. RAST-class 3 could be measured with the serum of this patient using E.e. wood and artemisia vulgaris (A.v. pollen) allergen disks. RAST-inhibition, western-blot (WB) and immunoprint (IP) indicated common allergens in extracts of E.e. wood and A.v. pollen of different degree. In addition this study indicated that subjects suffering from A.v. pollen allergy also show sensitization to E.e. wood since in 22 of 37 A.v. pollen allergies A.v. (RAST class 2-4) IgE-antibodies could be seen. The present case probably demonstrates for the first time an IgE-mediated type I allergy to E.e. wood.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
3/3. Respiratory diseases and food allergy.Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect such as gastroesophageal reflux, a congenital defect of the heart or tracheo-bronchial tree, an immunodeficiency syndrome such as isolated IgA or IgG4 deficiency, or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy. When it occurs in conjunction with lung disease, it may be a helpful indicator of activity of the allergic lung disease and of the patient's compliance in following a specific diet. Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. Lower respiratory tract involvement is generally associated with a greater delay in onset of symptoms and with a larger quantity of allergen ingestion than chronic rhinitis. food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |