1/138. Fingertip dermatitis in an ophthalmologist caused by proparacaine.PURPOSE: To report the late diagnosis of allergic response to proparacaine hydrochloride in an ophthalmologist. METHOD: Case report. In a 49-year-old practicing ophthalmologist, the history, clinical findings of fingertip dermatitis, skin pathology, and skin patch testing are described. RESULTS: Proparacaine, as the initiating agent, took almost 3 years to identify because of the unusual pattern of allergy. We explored numerous treatment options before identifying and removing the offending agent. CONCLUSIONS: Ophthalmologists may be exposed to proparacaine on a daily basis. This unique report heightens the awareness of this rare work-related complication.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
2/138. Occupational protein contact dermatitis to cornstarch in a paper adhesive.BACKGROUND: Protein contact dermatitis is better known in food-service and health-care workers than in industrial workers. Cornstarch has seldom been a problem, although it can cause contact urticaria to glove powder. OBJECTIVE: To present the case of a paper-bag maker who developed severe occupational (protein) contact dermatitis within two-three hours after returning to work. She lacked any evidence of urticaria and demonstrated largely negative patch-test results. methods: Following a history of occupational exposure to a cornstarch-based adhesive, the patient was patch-tested to materials with which she had worked, which she contacted, and with which she had attempted treatment. Following patch testing, she was prick-tested to cornstarch, the principal ingredient in the adhesive. RESULTS: Patch testing was negative except for a very mild reaction to the adhesive. Prick testing to cornstarch was more severe than the histamine control. The test site became eczematous and remained so for more than ten weeks. Avoidance of cornstarch and the adhesive was followed by clearing. CONCLUSION: Workup for prominent occupational contact dermatitis without urticaria may sometimes require testing for type 1 allergy.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
3/138. Aplastic anemia in a petrochemical factory worker.A petrochemical worker with aplastic anemia was referred to our hospital. He worked in a petroleum resin-producing factory and had been exposed to low-level benzene while packaging the powder resin and pouring lime into a deactivation tank. According to the yearly environmental survey of the working area, the airborne benzene level was approximately 0.28 ppm. Exposure to benzene, a common chemical used widely in industry, may progressively lead to pancytopenia, aplastic anemia, and leukemia. The hematotoxicity of benzene is related to the amount and duration of exposure. Most risk predictions for benzene exposures have been based on rubber workers who were exposed to high concentrations. In the petroleum industry, the concentration of benzene is relatively low, and there are disputes over the toxicity of low-level benzene because of a lack of evidence. In this paper we report the case of aplastic anemia induced by low-level benzene exposure.- - - - - - - - - - ranking = 0.026428362798409keywords = rubber (Clic here for more details about this article) |
4/138. Sensitization to oilseed rape is not due to cross-reactivity with grass pollen.BACKGROUND: Oilseed rape is an important crop grown in the UK which can cause specific immunological sensitization with clinical symptoms in a relatively small number of the general population. Individuals with immunoglobulin (Ig) E-mediated allergy to oilseed rape have also been found to be sensitized to other pollen allergens, most frequently being grass pollen. Cross-reactivity between common grass and oilseed rape would have important implications, especially as their flowering period coincides. OBJECTIVE: We have investigated whether the cosensitization found in individuals sensitized to both oilseed rape and grass pollen is due to cross-reactivity. methods: Cross-reactivity between oilseed rape and grass pollen was determined using RAST, RAST inhibition, Western blotting and inhibition studies with Western blotting. RESULTS: Competitive RAST inhibition studies between pollen of oilseed rape and grass failed to show any cross-reactivity between the pollen types. Self-inhibition with oilseed rape resulted in 90% inhibition, whereas there was less than 10% inhibition with grass pollen. Western blotting revealed allergens of similar molecular weight in both oilseed rape and grass pollen. Despite allergens of similar molecular weights being present in both pollen types, inhibition immunoblot studies confirmed that the allergens in the two allergens were immunologically distinct. CONCLUSION: The allergens of oilseed rape and grass pollen, although similar in molecular weights, are immunologically distinct and there is no evidence of cross-reactivity between them. Individuals allergic to grass pollen will not necessarily develop a specific nasal or airway response to inhaled oilseed rape pollens.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
5/138. Successful treatment of occupational allergy to bumblebee venom after failure with honeybee venom extract.BACKGROUND: Immediate-type allergies to bumblebee stings occur infrequently. Previous studies have demonstrated a high degree of cross-reactivity between honeybee venom (HBV) and bumblebee venom (BBV). It has been proposed that venom immunotherapy (VIT) with HBV is a therapeutic alternative for patients with BBV allergy. methods AND RESULTS: We present two cases of occupational immediate-type allergies to BBV. Although both nonatopic patients had a negative personal history of previous allergic reactions to honeybee sting, specific IgE antibodies and a positive intradermal reaction to HBV were detected. Despite VIT with HBV, the two developed another severe allergic reaction after incidental bumblebee stings. VIT with BBV, using in one patient a rush protocol and in the other a "conventional" regimen, with escalating doses of 0.01-100 microg of BBV, was performed. Before and during the VIT, the course of IgE and IgG specific antibodies to BBV was analyzed, demonstrating a significant decrease of BBV-IgE and an increase of BBV-IgG. The effectiveness of the treatment was also proven by an in-hospital sting challenge with a live bumblebee. CONCLUSIONS: Our data demonstrate that cross-immunotherapies with HBV do not protect BBV-allergic patients sufficiently. We conclude that BBV-allergic patients should be treated with BBV. A "rush" VIT with BBV is a safe alternative to a "conventional" protocol.- - - - - - - - - - ranking = 5keywords = allergy (Clic here for more details about this article) |
6/138. Aluminium allergy in a patient with occupational contact dermatitis.Case of a 57-year-old hospital attendant with hand eczema. patch tests were read at 2 and 3 days using the 1 to 3 scoring system recommended by the Contact dermatitis research Group.- - - - - - - - - - ranking = 4keywords = allergy (Clic here for more details about this article) |
7/138. 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 = 7keywords = allergy (Clic here for more details about this article) |
8/138. Is "latex safe" possible? Using a systematic approach in occupational health.1. Exposure to natural rubber latex, either by contact or by inhalation, can pose an extreme workplace hazard for sensitive health care workers. latex reduction strategies are necessary to provide a safer work environment for those who are sensitive, and to prevent future sensitization of healthy workers. 2. Developing a latex reduction plan requires a multifaceted approach. An interdisciplinary task force is highly recommended to achieve optimal latex reduction. 3. Educating staff about latex safety for both health care workers and the patient population is important in providing a safer work environment.- - - - - - - - - - ranking = 17.88246421581keywords = latex, rubber (Clic here for more details about this article) |
9/138. Respiratory syndrome very similar to extrinsic allergic alveolitis due to penicillium verrucosum in workers in a cheese factory.A respiratory syndrome very similar to extrinsic allergic alveolitis due to penicillium verrucosum was recognized in 4 workers employed in a Gorgonzola cheese factory. A mycogen allergy to P. verrucosum, used as starter in the production, was demonstrated by positive sputum culture and detection of specific antibodies in the blood. Intense and prolonged exposure to inhalation of fungal spores could have lead to the development of this allergic response. The fact that 2 of the subjects are siblings seems to indicate host susceptibility or immunological constitution in the pathogenesis of the respiratory allergy.- - - - - - - - - - ranking = 2keywords = allergy (Clic here for more details about this article) |
10/138. Baker's asthma due to xylanase and cellulase without sensitization to alpha-amylase and only weak sensitization to flour.BACKGROUND: The baking additives xylanase and cellulase were described as baking additives causing baker's asthma. It is not known whether monosensitization to these enzymes may occur. methods: We present a case report of a baker with work-related asthma evaluated by skin prick test (SPT), enzyme-linked immunosorbent assay (EAST), immunoblot, EAST and immunoblot inhibition, and specific bronchial challenge. Fungal xylanase and alpha-amylase were measured by two-site enzyme immunoassays in products used by the patient at work. RESULTS: Allergy to xylanase and cellulase was demonstrated by SPT, EAST, immunoblot and specific bronchial challenge (for xylanase only). No sensitization to alpha-amylase could be demonstrated, but there was a weak flour allergy as documented by EAST and immunoblot and a positive occupational-type challenge with high concentrations of rye flour. Four baking additives contained measurable amounts of fungal alpha-amylase and xylanase, without a correlation between these enzymes. CONCLUSIONS: We conclude that occupational asthma due to the baking additives xylanase and cellulase may occur without concomitant sensitization to alpha-amylase and only weak sensitization to flour.- - - - - - - - - - ranking = 1keywords = allergy (Clic here for more details about this article) |
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