Cases reported "Conjunctivitis, Allergic"

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1/34. Facial dermatitis, contact urticaria, rhinoconjunctivitis, and asthma induced by potato.

    BACKGROUND: Potato contains multiple heat-labile proteins which can induce immediate hypersensitivity reactions. Rhino-conjunctivitis, asthma, contact urticaria and protein contact dermatitis have been described in association with potato exposure. OBJECTIVE: A patient with possible airborne facial dermatitis to potato is described. RESULTS: A middle-aged atopic housewife with pre-existent atopic dermatitis suffered from rhino-conjunctivitis, asthma, and contact urticaria when pealing raw potatoes, but her main complaint was intense, treatment-resistant dermatitis of the face. The investigations showed a positive prick test, a positive patch test, and positive specific serum IgE to raw potato. Potato avoidance led not only to the resolution of the immediate symptoms, but also of the facial dermatitis, suggesting she had dermatitis due to this vegetable. CONCLUSIONS: Potato may induce contact dermatitis with positive immediate and delayed hypersensitivity tests.
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2/34. Occupational IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria caused by Easter lily (lilium longiflorum) and tulip.

    BACKGROUND: We report on IgE-mediated asthma, rhinoconjunctivitis, and contact urticaria to two liliaceae plants, tulip and Easter lily (lilium longiflorum), diagnosed in a floral shop worker. methods: Occupational asthma was diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test. Flower-specific IgE was studied, and RAST inhibition tests were performed. RESULTS: skin prick testing showed positive reactions to tulip, Easter lily, and chrysanthemum. Total IgE was 180 kU/I, and specific IgE to tulip was 2.6 and to Easter lily 6.5 kU/I. In the RAST-inhibition test, no cross-reactivity was found. Occupational asthma was diagnosed by peak flow monitoring at work and at home, as well as specific inhalation challenge with Easter lily, with an immediate 18% reduction in PEF. In addition, contact urticaria and conjunctivitis were diagnosed. After a 9-year follow-up without exposure to lilies, the skin prick tests to L. longiflorum and tulip were still positive, but the specific IgE had disappeared. CONCLUSIONS: A case of IgE-mediated occupational asthma, rhinoconjunctivitis, and contact urticaria caused by L. longiflorum and tulip is presented. RAST inhibition tests indicated concomitant sensitization to the two liliaceae plants.
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3/34. Occupational asthma caused by champignon flies.

    BACKGROUND: Occupational bronchial asthma in mushroom (champignon) workers is unusual, although reports on it appeared in 1938 and 1951; we have not found any others since those dates. Here we report the case of a 52-year-old man who works as a champignon cultivator. He suffered rhinoconjunctivitis and asthma attacks whenever he entered the champignon culture caves. We studied flies as a possible antigen source. We collected these insects from the growing sites in order to identify them, and then prepare an extract; the samples turned out to be of two families of insects of the order diptera, 98% from the Phoridae family (Brachycera suborder) and 2% from the Sciaridae (Nematocera suborder). methods: skin prick tests, conjunctival provocation tests, serum specific IgE, specific IgE-binding fractions in immunoblotting, and monitoring of PEFR (at work and off work) were performed. RESULTS: IgE-mediated hypersensitivity to these flies was demonstrated by skin prick test, conjunctival provocation test, serum specific IgE, and IgE-binding fractions in immunoblotting. Monitoring of PEFR both at work and off work showed a clear relationship between symptoms, or fall in PEFR, and the workplace. CONCLUSIONS: We report the case of a patient suffering from asthma and rhinoconjunctivitis caused by hypersensitivity to fly proteins.
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4/34. Allergy to an occupational allergen (Sapelli wood) in a child.

    The case is presented of a child who developed rhinoconjunctivitis, angioedema and asthma by sensitization to Sapelli wood, which was used in his father's carpentry. Positive skin-prick test, high levels of specific immunoglobulin e by ELISA and a positive conjunctival challenge test suggest a type I hypersensitivity mechanism to this wood. This is the first case report of sensitization to Sapelli wood and it confirms that occupational allergen exposure as Sapelli wood may also cause sensitization in a child.
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5/34. 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.
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6/34. Rhinoconjunctivitis and occupational asthma caused by Diplotaxis erucoides (wall rocket).

    Wall rocket (Diplotaxis erucoides) is a common Crucifera plant that grows in European and American vineyards and olive groves. We present the cases of 2 farmers with rhinoconjunctivitis and asthma related to wine-growing tasks during D erucoides pollination (March-April). The aim of this work was to demonstrate that occupational symptoms were caused by D erucoides pollen sensitization. Cutaneous tests, specific IgE measurements, conjunctival and bronchial provocation tests, and peak-flow measurements during working days were performed.
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7/34. Dentist's occupational asthma, rhinoconjunctivitis, and allergic contact dermatitis from methacrylates.

    BACKGROUND: Allergic contact dermatitis (ACD) caused by (meth)acrylates (MA) is common in dental personnel. MAs have also caused asthma and rhinoconjunctivitis, but asthma, rhinoconjunctivitis and ACD caused by MAs in the same patient appears to be very rare. methods: Occupational asthma and rhinoconjunctivitis were diagnosed in a dentist according to patient history, PEF monitoring, and a work-simulated bronchial provocation test. ACD was diagnosed by skin-patch testing with MAs with the occlusive Finn Chamber-technique. RESULTS: The patient's skin-prick test reactions to common environmental allergens and MAs were negative. The total IgE was not elevated. Occupational asthma was diagnosed by a specific inhalation challenge test in which the patient handled liquid dental MAs for 30 min causing a delayed 23% reduction in FEV1. The provocation test also resulted in rhinoconjunctivitis. On patch testing, positive reactions were provoked by several MAs including 2-hydroxyethyl methacrylate (2-HEMA) to which the patient was occupationally exposed. The patient has not been able to continue her work with dental MAs. CONCLUSIONS: A case of occupational asthma, rhinoconjunctivitis and ACD caused by dental acrylate compounds is presented. patients with respiratory hypersensitivity from MAs have to stop working with MAs, whereas patients with ACD from MAs need to avoid direct contact with MAs, but can often continue in their present job if they use no-touch techniques.
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8/34. Occupational rhinoconjunctivitis and asthma in a wool worker caused by Dermestidae spp.

    BACKGROUND: The family Dermestidae belongs to the order Coleoptera. Occupational allergy has been described in museum personnel. A 31-year-old male wool worker presenting rhinoconjunctivitis and asthma episodes probably linked to exposure to Dermestidae-infected wool was investigated. methods: Extracts prepared either from insect bodies or from dust from parasitized wool were used for skin prick testing (SPT), conjunctival and bronchial provocation tests and in vitro determinations. RESULTS: SPT and provocation tests were positive to both extracts. PEFR measurement demonstrated the association between the patient's symptoms and occupational exposure to Dermestidae. Specific IgE to both extracts was detected and immunoblotting revealed several protein bands from 5 to 200 kDa that were reactive to IgE from the patient's serum. CONCLUSIONS: Dermestidae exposure in wool workers when handling parasitized wool can be a cause of IgE-mediated rhinoconjunctivitis and asthma.
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keywords = asthma
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9/34. A case of anaphylaxis due to rose pollen ingestion.

    BACKGROUND: Recent publications have demonstrated that in Guneykent (turkey), a rose-cultivating area, some workers experience various allergic reactions due to contact with rose or its pollen. CASE REPORT: A 47-year-old man, originally from Guneykent although he no longer lived there, suffered perennial rhinitis, asthma and rhinoconjunctivitis in spring related to sensitization to dust mites and various pollens, respectively. On several occasions, he had presented oral and cutaneous symptoms and angioedema due to contact with rose or intake of honey or other products. Finally, he had an anaphylactic reaction on drinking dew collected in the tulips of a rose that possibly contained rose pollen. methods: Specific IgE was evaluated with rosa rugosa extract and was 30.3 IU (class IV). Sensitization to other pollens and to mites was also confirmed. Oral provocation test was not deemed ethical. CONCLUSION: This may be the first reported case of anaphylactic reaction due to rose pollen ingestion.
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10/34. Acute asthma attack caused by ophthalmic application of antiallergic agents.

    BACKGROUND: To investigate the induction of acute asthmatic attacks caused by several kinds of antiallergic eyedrops for the treatment of allergic conjunctival diseases in a patient with bronchial asthma and aspirin sensitivity. CASE: A 42-year-old man with a 10-year history of bronchial asthma and with aspirin sensitivity, who had been given disodium cromoglycate (DSCG) to be applied topically, developed asthma after applying DSCG drops. OBSERVATIONS: After the instillation of DSCG, tranilast, ibudilast, and ketotifen, the peak expiratory flow rate (PEFR) decreased in this patient and asthmatic signs developed. However, there was no decrease in the PEFR after challenge with pemirolast, levocabastine, or fluorometholone (0.1%) eyedrops, or saline as control. CONCLUSIONS: This case suggests that mast-cell-stabilizer eyedrops might induce an asthma attack in patients with a history of asthma and aspirin or nonsteroidal antiinflammatory drug allergy. Mast-cell-stabilizing eyedrops should be prescribed for such patients with special precautions unless the patient is known to tolerate mast cell stabilizers without difficulty.
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