A baker's occupational allergy to flour moth (Ephestia kuehniella).
BACKGROUND
Allergy to insects is common. However, few reports cover occupational sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). We describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth.


METHODS
The skin prick test (SPT) and serum IgE tests were used to evaluate the patient's sensitivity to flour moth. Allergen cross-reactivity with mites was evaluated in IgE-inhibition studies. Clinical sensitivity was evaluated by nasal challenge test. Pulmonary function tests were repeatedly monitored.


RESULTS
SPT with flour moth gave a 6-mm wheal, and an elevated level of flour moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). Immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, and >86 kDa in the extract of flour moth. Allergen cross-reactivity with mites was demonstrated in inhibition studies. Immediate-type allergy to flour moth was confirmed by nasal challenge. Increased daily variability of PEF values was observed during workplace exposure.


CONCLUSIONS
A baker's occupational respiratory allergy to flour moth was confirmed.
Mäkinen-Kiljunen
S
S
Division of Allergology, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Mussalo-Rauhamaa
H
H
Petman
L
L
Rinne
J
J
Haahtela
T
T
D000328:Adult; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D005433:Flour / Q000009:adverse effects; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D009036:Moths / Q000276:immunology*; D009784:Occupational Diseases / Q000209:etiology* / Q000276:immunology; D012130:Respiratory Hypersensitivity / Q000276:immunology*; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000379:methods
D000485:Allergens; D007073:Immunoglobulin E