1/4. Specific sensitization to the common housefly (Musca domestica) not related to insect panallergy.BACKGROUND: Allergy to houseflies is rare. We report a case of respiratory allergy from occupational exposure to houseflies in a farmer. CASE REPORT: A 30 year-old female farmer with a long-standing history of grass pollen allergy observed for 2 years rhino-conjunctivitis and mild asthma when entering livestock stables and barns. Allergy retesting revealed sensitization to various pollens but not to animal danders. houseflies (Musca domestica) occurring on the farm in great quantity were suspected by the farmer herself as the causative agent. RESULTS: Skin prick testing with housefly was positive in the patient and negative in four controls. Experimental radioallergosorbant test was class 3 positive. Sensitization to house dust mite, storage mites and cockroach was not detectable. Western blots with housefly extracts revealed immunoglobulin e (IgE)-binding to bands of 70, 50, and approximately 16 kDa. tropomyosin in the housefly extract (35 kDa) was recognized by a tropomyosin reference serum but not by the patient. In enzyme-linked immunosorbent assay (ELISA) inhibition assays using housefly as the solid phase, IgE-binding of the patient was inhibited by 75% by M. domestica and by 44% by the closely related lesser housefly (Fannia canicularis), but not by extracts from blowfly (Lucilia spp.), fruit fly (drosophila spp.), horsefly (Haematopota pluvialis) and mosquito (culex pipiens). The IgE-binding of the tropomyosin control serum was inhibited by 60-80% by all species. CONCLUSIONS: In accordance with previous reports, this case demonstrates that respiratory sensitization to insects may be highly specific. According to ELISA inhibition, cross-sensitization in the present case was restricted to species of the family of true flies (muscidae).- - - - - - - - - - ranking = 1keywords = grass (Clic here for more details about this article) |
2/4. Biphasic systemic anaphylactic reaction: three illustrative cases.We report on three patients with early mild systemic reactions triggered by administration of rabies vaccine, immunotherapy with rye grass extract, or yellow jacket sting. After appropriate treatment, these early cutaneous and respiratory symptoms improved considerably, but then flared up three and one half to four hours later. All three patients had specific IgE antibodies against their offending allergen.- - - - - - - - - - ranking = 1keywords = grass (Clic here for more details about this article) |
3/4. Do latex allergens potentiate other skin tests?We report the case of a 33 year old atopic female patient, who worked for the last 4 years as a cleaner in the surgical area of a hospital. One year after starting the work in this area, the patient noticed upper respiratory symptoms and soon later dyspnea immediately after entering the operating room. Other allergic symptoms were perennial rhinoconjunctivitis and urticaria after contact with peaches. Common skin prick tests were positive for dermatophagoides pteronyssinus. Fifteen min later a skin prick test with latex was done with a strong positive result after 10 min. At the same time, several allergens (cat dander, grass and olive pollens) showed positive results. The patient experienced a fall in the FEV1 that returned to basal levels after two inhalations of a bronchodilator. New skin tests to common allergens performed one week later were only positive to mites.- - - - - - - - - - ranking = 1keywords = grass (Clic here for more details about this article) |
4/4. Inhalant atopic sensitivity to grasshoppers in research laboratories.BACKGROUND: Atopic sensitivity to insects, in both occupational and nonoccupational settings, is common. methods: A 26-year-old man with atopic asthma experienced worsened asthma and urticaria on exposure to grasshoppers in a research laboratory; he along with 16 other persons who work with grasshoppers from two laboratories and 26 control subjects were studied. The patient underwent a controlled allergen inhalation test with aqueous grasshopper dropping antigen. All subjects were assessed by means of a questionnaire. All but one (who refused because of severe skin reactions after contact with grasshoppers) had skin prick tests with three extracts of grasshopper and with grass pollen, cat dander, and dermatophagoides farinae. RESULTS: The allergen challenge was positive with an isolated early asthmatic response (23% fall forced expiratory volume in 1 second [FEV1]) at 1:4096 (approximately 25 micrograms/ml), and a borderline fall in provocative concentration of methacholine causing a 20% fall in FEV1. Seven of 16 (43.8%) workers had positive grasshopper skin test results compared with one of 26 (3.8%) control subjects (p = 0.0052). Sensitization occurred even in otherwise nonatopic workers (5 of 12). Symptoms of asthma on exposure (n = 4) correlated better with positive skin test results than did cutaneous symptoms (n = 8). CONCLUSION: Atopic sensitization to grasshoppers in research laboratories is a significant occupational health problem.- - - - - - - - - - ranking = 12keywords = grass (Clic here for more details about this article) |