Allergy Asthma Immunol Res.  2011 Apr;3(2):132-134. 10.4168/aair.2011.3.2.132.

New Sensitization to House Dust Mites in Cefteram-Induced Occupational Asthma: A Case Report

• Jin HJ
• Kim JE
• Kim JH
• Ye YM
• Park HS

• KMID: 2130366
• DOI: http://doi.org/10.4168/aair.2011.3.2.132

Abstract

Occupational asthma (OA) can improve after cessation of exposure; however, some patients suffer from persistence or aggravation of their asthmatic symptoms. Here we report a case of a new sensitization to house dust mites during the follow-up period in a 37-year-old female patient with OA induced by cefteram pivoxil powder (cefteram powder). She was previously diagnosed with OA caused by inhalation of cefteram powder. Consequently, she left her job and had been well for 9 subsequent years. She began to experience aggravation of her rhinitis and asthmatic symptoms again several months prior to presentation. Her skin-prick test results had converted to strongly positive responses to two types of house dust mites. The serum levels of eosinophil cationic protein (ECP) and the total and specific immunoglobulin (Ig)E levels against the two types of house dust mites were elevated. An inhalation challenge test with Dermatophagoides farinae was performed, and significant bronchoconstriction (21.1% reduction in the forced expiratory volume in the first second) with asthma symptoms was observed at 10 minutes. To our knowledge, this is the first case demonstrating a new sensitization to house dust mites in a patient with OA caused by cefteram powder. Regular monitoring, including skin-prick tests and measurement of specific serum IgE/ECP levels, may help to screen potential cases.

Keyword

Asthma; cefteram; Dermatophagoides farinae; occupation

MeSH Terms

Adult
Asthma
Asthma, Occupational
Bronchoconstriction
Cefmenoxime
Dermatophagoides farinae
Dust
Eosinophil Cationic Protein
Female
Follow-Up Studies
Forced Expiratory Volume
Humans
Immunoglobulins
Inhalation
Occupations
Pyroglyphidae
Rhinitis
Cefmenoxime
Dust
Eosinophil Cationic Protein
Immunoglobulins

Reference

1. Rachiotis G, Savani R, Brant A, MacNeill SJ, Newman Taylor A, Cullinan P. Outcome of occupational asthma after cessation of exposure: a systematic review. Thorax. 2007. 62:147–152.

2. Kang SK, Jee YK, Nahm DH, Min KU, Park JW, Park HS, Son CH, Cho SH, Choi I, Choi SW, Hong CS, Kim KS, Cho SH, Kim YY. A status of occupational asthma in Korea through the cases reported to the Occupational Asthma Surveillance Center. J Asthma Allergy Clin Immunol. 2000. 20:906–915.

3. Park HJ, Kim HA, Hur GY, Ye YM, Suh CH, Nahm DH, Park HS. Prevalence and clinical significance of new sensitization to inhalant allergens in toluene diisocyanate-induced asthmatic patients. Korean J Asthma Allergy Clin Immunol. 2006. 26:213–218.

4. Park HS. Newly sensitization to house dust mite in an isocyanate-induced asthmatic patient. Korean J Allergy. 1995. 15:85–89.

5. Menon MP, Das AK. Tetracycline asthma--a case report. Clin Allergy. 1977. 7:285–290.

6. Stenton SC, Dennis JH, Hendrick DJ. Occupational asthma due to ceftazidime. Eur Respir J. 1995. 8:1421–1423.

7. Suh YJ, Lee YM, Chung JH, Song HJ, Jung JW, Lee EH, Suh CH, Nahm DH, Park HS. Occupational asthma and IgE sensitization induced by inhalation of cefteram pivoxil powder. J Asthma Allergy Clin Immunol. 2002. 22:614–619.

8. Ye YM, Kim HM, Suh CH, Nahm DH, Park HS. Three cases of occupational asthma induced by thiamphenicol: detection of serum-specific IgE. Allergy. 2006. 61:394–395.

9. Kammermeyer JK, Mathews KP. Hypersensitivity to phenylglycine acid chloride. J Allergy Clin Immunol. 1973. 52:73–84.

10. Coutts II, Dally MB, Taylor AJ, Pickering CA, Horsfield N. Asthma in workers manufacturing cephalosporins. Br Med J (Clin Res Ed). 1981. 283:950.

11. Lagier F, Cartier A, Dolovich J, Malo JL. Occupational asthma in a pharmaceutical worker exposed to penicillamine. Thorax. 1989. 44:157–158.

12. Park HS, Nahm DH. Prognostic factors for toluene diisocyanate-induced occupational asthma after removal from exposure. Clin Exp Allergy. 1997. 27:1145–1150.

13. Saetta M, Maestrelli P, Di Stefano A, De Marzo N, Milani GF, Pivirotto F, Mapp CE, Fabbri LM. Effect of cessation of exposure to toluene diisocyanate (TDI) on bronchial mucosa of subjects with TDI-induced asthma. Am Rev Respir Dis. 1992. 145:169–174.

14. Nguyen B, Ghezzo H, Malo JL, Gautrin D. Time course of onset of sensitization to common and occupational inhalants in apprentices. J Allergy Clin Immunol. 2003. 111:807–812.

15. Koh GC, Shek LP, Goh DY, Van Bever H, Koh DS. Eosinophil cationic protein: is it useful in asthma? A systematic review. Respir Med. 2007. 101:696–705.

16. Rasmussen F, Lambrechtsen J, Siersted HC, Hansen HS, Hansen NC. The Odense Schoolchild Study. Increased eosinophil cation protein level in sensitized nonasthmatics is linked to subsequent hyperresponsiveness to methacholine. Int Arch Allergy Immunol. 2000. 121:129–136.

17. Adamko DJ, Wu Y, Ajamian F, Ilarraza R, Moqbel R, Gleich GJ. The effect of cationic charge on release of eosinophil mediators. J Allergy Clin Immunol. 2008. 122:383–390.e4.