title: A case of occupational rhinitis caused by porcine pancreatic extract developing into occupational asthma.
abstract: Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of alpha-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete.
authors.affiliation: Department of Otolaryngology, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Seung Youp
authors.initials: SY
authors.lastname: Shin
authors.forename: Gyu Young
authors.initials: GY
authors.lastname: Hur
authors.forename: Young Min
authors.initials: YM
authors.lastname: Ye
authors.forename: Hae Sim
authors.initials: HS
authors.lastname: Park
mesh_terms: D000328:Adult; D000818:Animals; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology; D001985:Bronchial Provocation Tests; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism; D016210:Methacholine Chloride / Q000494:pharmacology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology; D010184:Pancreatic Extracts / Q000009:adverse effects*; D011208:Powders; D012220:Rhinitis / Q000175:diagnosis* / Q000209:etiology; D012882:Skin Tests; D013552:Swine
chemical_list: D005765:Gastrointestinal Agents; D010184:Pancreatic Extracts; D011208:Powders; D016210:Methacholine Chloride; D007073:Immunoglobulin E