title: [Bronchopneumopathy caused by wheat flour: analysis of clinical cases].
abstract: We studied 31 subjects exposed to wheat (mean work duration: 33 years) with chronic bronchopulmonary disease. 19 subjects complained of chronic cough and phlegm, 5 of symptoms of bronchoconstriction not associated to chronic cough and phlegm; 7 subjects complained of oculo-rhinitis. Subjects with symptoms of bronchoconstriction had a longer mean age and work duration than the other ones. Pulmonary function tests showed a slight decrease of mid-expiratory flow rate with respect to reference values. Skin reactivity to common allergens and to allergenic extracts of wheat flour and grain was low, but a relevant number of dubious responses (weal: 3-4 mm) to specific allergens was observed. Bronchial hyperresponsiveness to methacholine or bethanechol was observed in 17 out of 30 subjects, and a positive response to occupational-type specific bronchial provocative test (sBPT) was elicited in 10 out of 30 subjects. There was a low relationship between positive response to sBPT and symptoms of bronchoconstriction or skin reactivity to specific allergens. These observations suggest that a high prevalence of chronic bronchitis and/or chronic airway limitation is showed in workers long-term exposed to wheat flour, in front of a low prevalence of skin reactivity to flour and grain. Occupational-type sBPT might induce in these patients a non immunological positive response to wheat flour by means of a not completely known mechanism.
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000209:etiology; D001982:Bronchial Diseases / Q000175:diagnosis / Q000209:etiology*; D001985:Bronchial Provocation Tests; D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005433:Flour / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology*; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000209:etiology; D012882:Skin Tests
vernacular_title: Broncopneumopatia da farina: analisi di una casistica clinica.