1/10. 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.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/10. asthma and rhinitis induced by exposure to raw green beans and chards.BACKGROUND: Although the vast majority of IgE-mediated allergic reactions to foods occurs through ingestion, a few cases of unexpected allergic reactions to foods may occur through the exposure to airborne food allergen particles. methods: case reports. skin prick tests and serum-specific IgE (CAP-FEIA) were used to identify specific IgE antibodies. bronchial provocation tests were performed to determine the clinical relevance of inhaled exposure to raw and cooked green beans and raw chards. After demonstrating specific reactivity to them, SDS-PAGE and immunoblotting of raw and cooked green beans were carried out to identify relevant antigens. RESULTS: Three women developed bronchial asthma and rhinitis after exposure to raw green beans, and one of them also when exposed to raw chards. All women tolerated ingestion of green beans. patients reported multiple episodes while handling these vegetables for cooking activities. Allergy to green beans and chards was demonstrated by skin testing and serum-specific IgE. Bronchial challenge test with these allergens showed positive responses to raw, but not cooked, green beans and chards. Oral food challenges with green beans (raw and cooked) and chards were negative in all patients. In order to further characterize the allergenic components of these extracts, SDS-PAGE and electroblotting studies were also performed. Immunoblots of raw and cooked green beans extract showed two IgE-binding bands with apparent molecular weights of 41.1 and 70.6 kD. Interestingly, a 47-kD IgE-binding protein was detected only in raw green bean extracts. CONCLUSIONS: We report three patients who developed asthma and rhinitis caused by exposure to raw, but not to cooked, green beans and chards in a non-occupational environment. Only minor differences of IgE reactivity between nitrocellulose-blotted raw and boiled green bean extract were found.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/10. anaphylaxis to Cyphomandra betacea Sendth (tamarillo) in an obeche wood (Triplochiton scleroxylon)--allergic patient.BACKGROUND: anaphylaxis after the first exposure to a food allergen is uncommon unless a cross-reaction is present. OBJECTIVE: To investigate a possible relationship between the fruit Cyphomandra betacea Sendth (commonly known as tamarillo) and the wood of Triplochiton scleroxylon (obeche) in a patient with allergic occupational bronchial asthma due to obeche wood who began to experience anaphylaxis episodes after eating tamarillo. methods: A 33-year-old carpenter exposed to obeche wood in his occupation was initially seen with rhinitis and bronchial asthma. The causal relationship of these symptoms to obeche wood exposure was investigated by means of peak flow monitoring and bronchial inhalation testing. Furthermore, the patient had 2 acute episodes of anaphylaxis a few minutes after eating salad containing tamarillo. He had never tasted tamarillo before. The allergologic study included skin prick tests, serum specific IgE determinations, bronchial challenges, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting. RESULTS: Results of skin prick tests with common aeroallergens were negative. Strong skin prick test responses were obtained with obeche and tamarillo. Results of bronchial challenge testing with obeche extract were positive. In tamarillo extract, a 28-kDa band appeared as the most relevant IgE-binding antigen. A similar band of 28 kDa happens to be frequently detected in obeche-allergic patients. CONCLUSION: To our knowledge, this is the first reported case of anaphylaxis to tamarillo presented in a patient allergic to obeche, which raises the question of a new cross-reactivity antigen.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
4/10. Swiss chard hypersensitivity: clinical and immunologic study.Allergy to vegetables and fruits seems to be more prevalent in atopics, especially in birch pollen-sensitized individuals. We report a case of a grass pollen-sensitized woman, in whom the inhalation of vapor from boiling Swiss chard precipitated rhinoconjunctivitis and asthma. Type I hypersensitivity to Swiss chard was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, basophil degranulation, histamine release test, and an immediate bronchial provocation test response to Swiss chard extract. The controls did not react to any of these tests. RAST inhibition assays suggest the presence of some cross-reactivity among Swiss chard and grass pollen antigens, as well as cross-reactivity between vegetables and weed pollens of the chenopod family.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/10. 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 = antigen (Clic here for more details about this article) |
6/10. Housewives with raw potato-induced bronchial asthma.Allergy to white potato has rarely been described. We report two cases of atopic patients, housewives, in whom peeling raw potatoes precipitated rhinoconjunctivitis and asthmatic attacks, and, in one of them, contact urticaria. Type I hypersensitivity to raw potato antigens was demonstrated by means of immediate skin test reactivity, specific IgE determination by RAST, basophil degranulation, histamine release test and an immediate bronchial provocation test response to raw potato extract. The controls did not react to any of these tests. Potato allergenic constituent is currently being investigated but, as far as we know, it is heat-labile and has an MW of more than 10 Kd.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/10. Bakers' asthma caused by alpha amylase.Two bakers with bronchial asthma and two with rhinoconjunctivitis are described. Prick and RAST tests were positive with wheat flour in all of them, but the challenge test (nasal or bronchial) with wheat flour extract was positive only in one asthmatic baker. The prick test, RAST, and nasal or bronchial challenge done with alpha amylase extract (a glycolytic enzyme obtained from aspergillus oryzae and used as a flour additive) were positive in all four patients. Our results support previous data indicating that alpha amylase used in bakeries is an important antigen that could cause respiratory allergy in bakers. It can function as sole causative allergen or in addition with other allergens used in the baking industry.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/10. 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 = 1keywords = antigen (Clic here for more details about this article) |
9/10. psyllium laxative-induced anaphylaxis, asthma, and rhinitis.A 69-year-old nurse was evaluated for a recent episode of anaphylaxis that had occurred after psyllium ingestion. She had experienced recurrent rhinitis and asthma related to psyllium exposure for the past 15 years. The diagnosis of psyllium hypersensitivity was established by a positive psyllium puncture skin test, an elevated psyllium-specific IgE level in serum, and a confirmatory soluble-antigen competitive inhibition test. The patient was symptomatic for several years, and this diagnosis was not considered until she suffered potentially life-threatening anaphylaxis. psyllium hypersensitivity may be a more common phenomenon than is currently appreciated by physicians and other health-care providers.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/10. Granulomatous gastritis in Wegener's disease: differentiation from Crohn's disease supported by a positive test for antineutrophil antibodies.BACKGROUND: This report concerns the gastric manifestation of Wegener's granulomatosis in a 44 year old white female patient who initially presented with abdominal pain, vomiting, and iridocyclitis. FINDINGS: The clinical findings and the histopathological proof of granulomatous gastritis in the absence of necrotising vasculitis were initially considered to be indicative of a diagnosis of Crohn's disease showing isolated gastric involvement. A five month course of steroids resulted in temporary relief; thereafter the patient developed severe rhinitis with mucosal ulcerations. At this point biopsy of nasal mucosa disclosed the classic histopathological signs of Wegener's granulomatosis. A positive test for antineutrophil cytoplasmic antibodies (ANCAs) with a cytoplasmic pattern (c-ANCA) and antigenic specificity for proteinase 3 (PR-3) were found. The patient is in complete remission one year after diagnosis and treatment with steroids and cyclophosphamide. CONCLUSIONS: Wegener's granulomatosis can also involve the gastrointestinal tract. Granulomatous inflammation of the stomach, although a rare finding and non-specific, should include Wegener's disease in the differential diagnosis. The histological proof of necrotising vasculitis is dependent on the depth of the biopsy and therefore can be easily missed. Differential diagnosis can be clarified by ANCA testing.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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