title: Occupational asthma due to IgE mediated allergy to the flower Molucella laevis (Bells of Ireland).
abstract: BACKGROUND
  About 25% of greenhouse flower and/or ornamental plant growers sensitised to workplace flowers or moulds have occupational asthma, a disease that is suffered by 8% of the growers who cultivate these crops.
  
  
  OBJECTIVE
  To document a case of occupational asthma due to IgE mediated allergy to the flower Molucella laevis.
  
  
  METHODS
  and
  
  
  RESULTS
  There was a history of work related seasonal asthmatic and rhinoconjunctivitis symptoms in a Molucella laevis grower. Bronchial obstruction following exposure to Molucella laevis was documented by a fall in FEV(1) from 89% to 73% of predicted during seasonal exposure to Molucella laevis. Daily PEF measurements showed a fall from 500 to 250 l/min during this period following withdrawal of inhaled steroids. Bronchial reactivity to inhaled methacholine was increased (PC(20) 1.45 mg/ml). Confirmation of sensitisation to Molucella laevis flower pollen extract was done using an SPT and by demonstration of Molucella laevis specific serum IgE (18 IU/ml; class 4). Specific inhalation challenge with Molucella laevis extract provoked an early and late asthmatic reaction (EAR and LAR) with a fall in FEV(1) compared with control day of 40% and 53% respectively, with associated 5.1-fold increase in absolute sputum eosinophil cell counts and 2.9-fold increase in neutrophil cell counts.
authors.affiliation: Department of Allergology, Clinic for Internal Medicine, Groningen University Hospital, Hanzeplein 1, PO Box 30001, 9700 RB Groningen, Netherlands. w.m.a.j.miesen@int.azg.nl
authors.forename: W M A J
authors.initials: WM
authors.lastname: Miesen
authors.forename: S
authors.initials: S
authors.lastname: van der Heide
authors.forename: H A M
authors.initials: HA
authors.lastname: Kerstjens
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
authors.forename: J G R
authors.initials: JG
authors.lastname: de Monchy
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000032:analysis; D000420:Albuterol / Q000627:therapeutic use; D000485:Allergens / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy / Q000209:etiology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure; D011058:Pollen / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000395:Air Pollutants, Occupational; D000485:Allergens; D001993:Bronchodilator Agents; D007073:Immunoglobulin E; D000420:Albuterol