Occupational asthma caused by turbot allergy in 3 fish-farm workers.

We report 3 patients (26, 31, and 33 years) who worked at the same fish farm for several years. They experienced symptoms of rhinoconjunctivitis and bronchial asthma while classifying fish by size. Their asthma gradually worsened to the extent that it became persistent and required daily medication with inhaled corticosteroids and bronchodilators. Symptoms improved during weekends and holidays. All 3 patients could eat turbot. Our study showed that the patients were allergic and that sensitization was probably by inhalation. The allergens were parvalbumin in 1 case and a different allergen in the remaining 2 patients.

Acute ischaemic colitis due to hypotension and amoxicillin allergy.

A case of acute ischaemic colitis, confirmed by colonoscopy and colon biopsy, caused by IgE mediated allergy to amoxicillin is presented. The damage to the gut seemed to occur as a result of the hypotension suffered during the anaphylactic episode.

Nonpigmenting fixed drug eruption due to pseudoephedrine.

BACKGROUND: The nonpigmenting fixed drug eruption is a distinctive drug reaction characterized by large, tender and symmetric erythematous plaques that disappear with no residual pigmentation. METHODS: A case of a non-pigmenting fixed drug eruption due to pseudoephedrine is reported. RESULT: The reappearance of typical lesions at the same sites after oral challenge with 60 mg pseudoephedrine together with the absence of pigmentation confirm the diagnosis. CONCLUSION: A new case of proven nonpigmenting fixed drug eruption to pseudoephedrine is described.

Paracetamol (acetaminophen) hypersensitivity.

BACKGROUND: Paracetamol (acetaminophen) intolerance can occur in less than 5% of aspirin-sensitive subjects as a result of inhibition of prostaglandin synthesis but hypersensitivity to paracetamol without aspirin sensitivity is rare. METHODS: We report a case of an acute life-threatening hypersensitivity reaction to paracetamol. RESULTS: An oral challenge with 125 mg of paracetamol was carried out and followed by generalized anaphylactic reaction. An oral provocation test with 500 mg aspirin was well tolerated in the patient. CONCLUSION: An acute hypersensitivity reaction to paracetamol is described in this study. The results of the study suggest a real allergic mechanism rather than inhibition of prostaglandin synthesis as responsible.

Unsuspected sources of soybean exposure.

BACKGROUND: Hidden allergens in processed foods can provoke severe allergic reactions in sensitive individuals. The presence of soy proteins in typical Spanish sausage products (chorizo, salchichón, mortadella, and boiled ham), doughnut and soup stock cubes has not been reported previously. METHODS: The present article reports two examples of severe allergic reactions due to the ingestion of foods that unexpectedly contained soybean proteins. Allergollogic study included skin prick tests with the implicated foods and their components, serum specific IgE and bronchial and oral provocation tests. RESULTS: Skin test, serum-specific IgE, and bronchial and oral challenge tests (the latter, in one patient) were positive against soy and the above mentioned processed foods in which the presence of soybean flour was confirmed. CONCLUSIONS: This report demonstrates the importance of hidden allergens in allergic reactions to foods and the need to scrutinize closely every food component.

Occupational asthma and rhinitis caused by ash (Fraxinus excelsior) wood dust.

An 18-year-old man who worked in a furniture factory reported rhinitis and asthma when he was exposed to ash wood dust. Monitoring of the patient's peak expiratory flow rate (PEFR) when off work and at work showed increased variations of PEFR at work. Basal PC20 methacholine was 1.41 mg/ml. A bronchial provocation test (BPT) with a 1:1000 w/v ash wood dust extract induced a dual asthmatic response with a 7.5-fold increase of nonspecific bronchial responsiveness. Intradermal testing with ash wood extract elicited a positive immediate response. IgE antibodies against ash wood were found in the patient's serum with a RAST value of 0.57 PRU/ ml. Similar skin tests, BPT, and RAST with ash wood dust performed in control patients were all negative. All the studies performed suggest that our patient had occupational rhinitis and asthma caused by exposure to ash wood dust in which a type I immunologic mechanism was implicated.

[Extrinsic allergic alveolitis caused by Penicillium frequentans. Review and presentation of a case]. / Alveolitis alérgica extrínseca por Penicillium frequentans. Revisión y presentación de un caso.

We present a case of extrinsic allergic alveolitis due to Penicillium frequentans exposure (suberosis) at a cork factory. Diagnosis was based on clinical history, a restrictive spirometric pattern, evidence of reticular-nodular lung infiltrates on the X-ray, intradermal skin tests with dual reaction and precipitins-positive serum samples in the presence of the P. frequentans fungus. Although the patient refused to submit to a specific bronchial challenge, two natural challenges occurred when he once again happened to handle wet cork after leaving his previous job. The literature referring to this disease is reviewed.