title: Occupational rhinosinusitis due to etoposide, an antineoplastic agent.
abstract: OBJECTIVE
  This paper reports a rare case of an occupational hypersensitivity reaction to an antineoplastic agent.
  
  
  METHODS
  This is a clinical case report of a 45-year-old nurse who developed throat irritation and chronic nasal congestion followed by sinusitis shortly after beginning work at an oncological out-patient clinic. The symptoms disappeared upon leaving the clinic two years later, but they returned when she resumed work at the oncology unit at Hillerød Hospital, Denmark, handling chemotherapy on a daily basis. We performed in vitro histamine release tests against nine suspected antineoplastic agents.
  
  
  RESULTS
  The patient's histamine release test against the antineoplastic agent etoposide was positive; the other test results were negative. The histamine release test against etoposide using passive sensitization was also negative. Upon leaving the oncology department, the symptoms of the nurse disappeared once again. She was given a diagnosis of rhinosinusitis.
  
  
  CONCLUSIONS
  This case of a hypersensitivity reaction to etoposide was judged to be of occupational origin. It was not clear whether it was immunoglobulin E (IgE) or non-IgE mediated.
authors.affiliation: Clinic of Occupational Medicine, Hillerød Hospital, 3400 Hillerød, Denmark. hmeyer@dadlnet.dk.
authors.forename: Harald W
authors.initials: HW
authors.lastname: Meyer
authors.forename: Per
authors.initials: P
authors.lastname: Stahl Skov
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000506:poisoning; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D005047:Etoposide / Q000506:poisoning*; D005260:Female; D006636:Histamine Release / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects*; D009859:Oncology Nursing; D012220:Rhinitis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D012852:Sinusitis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide