title: Occupational rhinitis and bronchial asthma due to TBTU and HBTU sensitization.
abstract: Exposure to an increasing amount of products in the work environment is leading to new cases of occupational asthma among workers. We report the case of a worker at a pharmaceutical plant who developed occupational rhinitis and bronchial asthma due to HBTU: 2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate and TBTU: 2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate sensitization, two chemical products widely used in peptide synthesis and coupling. Skin tests (prick test) with HBTU and TBTU solutions in PBS were positive at a concentration of 1 mg/ml. Skin tests with the same solutions in 10 atopic controls yielded a negative result. Nasal challenge tests with these products were positive with HBTU at a concentration of 0.01 mg/ml and TBTU at a concentration of 1 mg/ml. In both cases PNIF (peak nasal inspiratory flow) decreased by more than 60% and severe sneezing and rhinorrhea were induced. Nasal challenge tests performed on 10 atopic controls with TBTU and HBTU at a concentration of 1 mg/ml were negative. We conclude that the patient presents occupational rhinitis and bronchial asthma due to TBTU and HBTU; the operational mechanism is probably immunological IgE-mediated given the positive prick tests and nasal challenge with these products.
authors.affiliation: Allergy Section, University General Hospital, Murcia, Spain. jmiralles1@meditex.es
authors.forename: J C
authors.initials: JC
authors.lastname: Miralles
authors.forename: J M
authors.initials: JM
authors.lastname: Negro
authors.forename: J M
authors.initials: JM
authors.lastname: Alonso
authors.forename: M
authors.initials: M
authors.lastname: García
authors.forename: F
authors.initials: F
authors.lastname: Sánchez-Gascón
authors.forename: J
authors.initials: J
authors.lastname: Soriano
mesh_terms: D000328:Adult; D001249:Asthma / Q000139:chemically induced*; D004345:Drug Industry; D006801:Humans; D007114:Immunization; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure; D012220:Rhinitis / Q000139:chemically induced*; D014230:Triazoles / Q000009:adverse effects*; D014508:Urea / Q000009:adverse effects* / Q000031:analogs & derivatives*
chemical_list: C487980:2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate; D014230:Triazoles; D014508:Urea; C074712:2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate