Occupational rhinosinusitis due to etoposide, an antineoplastic agent.
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.
Meyer
Harald W
HW
Clinic of Occupational Medicine, Hillerød Hospital, 3400 Hillerød, Denmark. hmeyer@dadlnet.dk.
Stahl Skov
Per
P
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
D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide