title: Anaphylaxis and allergic contact urticaria from occupational airborne exposure to HBTU.
abstract: We describe a case of anaphylaxis and allergic contact urticaria from occupational airborne exposure to HBTU (o-(benzotriazol-1-yl)-N,N,N',N'-tetramethyluronium hexafluorophosphate), which is a chemical used widely for solid and solution-phase peptide synthesis. Previously, the use of this chemical has been associated with occupational asthma, allergic contact urticaria and allergic contact dermatitis in individual cases, but not with anaphylaxis. Our diagnoses were based on the clinical symptoms, positive skin prick test (SPT) and positive skin provocation test to HBTU. The positive SPT indicates that the anaphylaxis reaction was IgE-mediated. We recommend that in the handling of HBTU, appropriate safety measures should be compulsory, and if work-related symptoms develop, the possibility of anaphylaxis should be considered in advising on appropriate work tasks.
authors.affiliation: Department of Occupational Medicine, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FI-02500 Helsinki, Finland. timo.hannu@ttl.fi
authors.forename: Timo
authors.initials: T
authors.lastname: Hannu
authors.forename: Kristiina
authors.initials: K
authors.lastname: Alanko
authors.forename: Helena
authors.initials: H
authors.lastname: Keskinen
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D000707:Anaphylaxis / Q000139:chemically induced*; D017449:Dermatitis, Allergic Contact / Q000188:drug therapy / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000188:drug therapy / Q000209:etiology*; D004837:Epinephrine / Q000627:therapeutic use; D004853:Epoxy Resins; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D019995:Laboratory Chemicals / Q000633:toxicity*; D008297:Male; D017056:Medical Laboratory Personnel; D014230:Triazoles / Q000633:toxicity*; D014508:Urea / Q000031:analogs & derivatives* / Q000633:toxicity; D014581:Urticaria / Q000139:chemically induced
chemical_list: D000395:Air Pollutants, Occupational; D004853:Epoxy Resins; D006634:Histamine H1 Antagonists; D019995:Laboratory Chemicals; D014230:Triazoles; D014508:Urea; C074712:2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate; D004837:Epinephrine