Christmas candy maker's asthma. IgG4-mediated pectin allergy.
We evaluated a 29-year-old candy maker with no history of asthma who developed asthma after exposure to pectin, a compound manufactured from fruits and fruit rinds. Following eight years of employment during which he added pectin to a recipe for Christmas candies, the candymaker developed acute respiratory symptoms. Challenge testing with the pectin mixture caused a 40 percent decrease in FEV1. Skin prick testing was positive to the pectin extract. Total IgE was normal and pectin-specific IgE antibodies were not detected. A strongly positive pectin-specific IgG4 antibody response was present that was not detected in a control serum and could be inhibited by the addition of pectin. Antigen-specific IgG4 should be sought in IgE negative cases of occupational asthma.
Kraut
A
A
MFL-Occupational Health Center, University of Manitoba, Winnipeg, Canada.
Peng
Z
Z
Becker
A B
AB
Warren
C P
CP
D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000276:immunology; D001985:Bronchial Provocation Tests; D002182:Candy; D005511:Food Handling; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis* / Q000276:immunology; D010368:Pectins / Q000009:adverse effects* / Q000276:immunology; D012882:Skin Tests
D007074:Immunoglobulin G; D010368:Pectins