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.
Cimarra
M
M
Department of Allergy, Hospital Clínico San Carlos, Madrid, Spain.
Martínez-Cócera
C
C
Chamorro
M
M
Cabrera
M
M
Robledo
T
T
Lombardero
M
M
Alonso
A
A
Catellano
A
A
Bartolome
J M
JM
D000363:Agaricales; D000818:Animals; D001249:Asthma / Q000209:etiology*; D003233:Conjunctivitis, Allergic / Q000209:etiology; D004175:Diptera / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology / Q000276:immunology; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000097:blood; D019476:Insect Proteins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010366:Peak Expiratory Flow Rate; D012220:Rhinitis / Q000209:etiology; D012882:Skin Tests
D019476:Insect Proteins; D007073:Immunoglobulin E