Occupational asthma due to esparto hypersensitivity in a building worker.
Esparto is a gramineous plant that has multiple applications in today's industry. Several cases of hypersensitivity pneumonitis (HP) caused by esparto inhalation have been reported, but only one case of asthma caused by Aspergillus fumigatus contaminating esparto has been communicated. We report a case of asthma induced by esparto inhalation in a 58-year-old man, who is a building industry worker, with subclinical sensitization to grass pollen. The relation between clinical symptoms and work activities was supported by peak expiratory flow (PEF) monitorization; PEF values decreased by 20% the days he handled esparto. Prick test with esparto was positive. Immunoblot analysis revealed several allergens in the esparto extract, some of them present in Lolium and A. fumigatus extracts. IgE immunoblot inhibition revealed a complete inhibition of lolium and A. fumigatus IgE reactive bands by esparto proteins. The patient then avoided the exposure to esparto at work and has remained asymptomatic for the last 2 years. In conclusion, this is a case of occupational asthma caused by esparto dust mediated by IgE antibodies. Proteins of A. fumigatus as well as proteins from this gramineous plant, which cross-reacted with esparto allergens, were responsible for the disease.
Department of Allergy of Hospital General Universitario Gregorio Marañon, Madrid, Spain. jrhornillos@gmail.com
Francisco Javier
FJ
Ruiz-Hornillos
Manuel
M
De Barrio Fernández
Pilar Tornero
PT
Molina
Itziar Sánchez
IS
Marcén
Galicia Davila
GD
Fernandez
María Rubio
MR
Sotés
María Luisa Baeza Ochoa
ML
de Ocariz
D000485:Allergens / Q000009:adverse effects; D000542:Alveolitis, Extrinsic Allergic / Q000175:diagnosis / Q000209:etiology*; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D001249:Asthma / Q000175:diagnosis / Q000209:etiology; D003252:Construction Materials; D004391:Dust / Q000032:analysis / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology; D010366:Peak Expiratory Flow Rate; D006109:Poaceae / Q000009:adverse effects* / Q000382:microbiology; D013172:Spores, Fungal / Q000276:immunology
D000485:Allergens; D004391:Dust; D007073:Immunoglobulin E