Adult onset egg allergy: a case report.

BACKGROUND: Egg allergy is one of the most frequent food allergies in childhood while adult onset of egg allergy is a rare condition. CASE PRESENTATION: We report the case of a 30 years old man sent to our center in order to investigate gastrointestinal symptoms occurring since 2 years after egg and derivatives intake. He did not suffer from egg or other food allergies in childhood. He is an active smoker with a contact dermatitis related to nickel and mild allergic rhinoconjunctivitis to grass pollen. Skin prick test and serum specific IgE to egg were performed and revealed sensitization to egg proteins. CONCLUSIONS: Even though IgE-mediated egg allergy affects children, this report witnesses a rare case of adult onset.

Ragweed allergy: Pollen count and sensitization and allergy prevalence in two Italian allergy centers.

BACKGROUND: Ragweed allergy represents a challenge for allergists due to its increase in some geographic areas, mainly northern Italy. OBJECTIVES: To compare two allergy centers in northern Italy by analyzing both the pollen count and the patient characteristics (sensitization and allergy prevalence) over a 10-year period. METHODS: Pollen counts for 10 years (2004-2013) were evaluated and compared in the two centers. Characteristics of patients who were sensitized and allergic to ragweed were analyzed. RESULTS: There was a significantly higher pollen count in Busto Arsizio than in Novi Ligure (p < 0.001). The patients who were seen in the Busto Arsizio center showed more frequent sensitization (p < 0.01) and allergy (p < 0.05) to ragweed than patients who were seen in the Novi Ligure center. The pollen count was significantly (p < 0.01) associated with sensitization and allergy difference. Allergic asthma was more frequent (p < 0.05) in Busto Arsizio. CONCLUSIONS: The pattern of sensitization and allergy prevalence seemed to be associated with ragweed pollen pressure, such as quantity. The knowledge of the pollen count is relevant in clinical practice, mainly for the management of patients with allergy.

Asthma and hairdressers.

PURPOSE OF REVIEW: Hairdressers have an increased prevalence of respiratory diseases and are at high risk of occupational asthma. In this paper we aim to review the most recent findings in respiratory diseases related to the occupation of hairdressing to provide a background for management and prevention. RECENT FINDINGS: Recent studies have described several cases of occupational asthma and occupational rhinitis in hairdressers. Persulphate salts are the major causal agents. Sensitization to persulphate salts seems more related to an individual hypersusceptibility than to environmental factors. An underlying immunologic mechanism is strongly suggested but not definitively demonstrated. The diagnosis of persulphate asthma is based on the specific challenge, for which standardized methods have been described. Some data show the presence of respiratory disorders in an early stage in apprentices and demonstrate that after diagnosis a proportion of hairdressers with occupational asthma remain symptomatic despite cessation of exposure. SUMMARY: Careful medical surveillance is recommended for hairdressers and for hairdressing apprentices. Further studies are needed to evaluate the mechanism of persulphate asthma and to determine the relative role of individual risk factors compared with environmental factors in the development of the disease.

Irritant vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome.

OBJECTIVES: This report describes a case of vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome (RADS). METHODS: A woman developed recurrent episodes of cough, dyspnea, and wheezing unresponsive to asthma therapy after irritant exposure to glutaraldehyde. Direct laryngoscopy was performed immediately after the induction of symptoms. RESULTS: Laryngoscopy showed a paradoxical adduction of the vocal cord on inspiration. Vocal cord dysfunction was diagnosed. CONCLUSIONS: A case of vocal cord dysfunction occurred after exposure to glutaraldhyde in a person with a history highly suggestive of RADS. Vocal cord dysfunction should always be considered in the differential diagnosis of patients with acute respiratory symptoms after exposure to irritants and with asthma-like symptoms that fail to respond to conventional asthma therapy.