Severe bronchial reaction to provocation with fish and crustaceans
Alexandra M. Preisser, Alexander M. Kraft, Volker Harth
Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
DOI 10.5414/ALX02129E
Abstract
The specific inhalation challenge (SIC), a workplace-related inhalation exposure test, is used to identify allergic asthma when symptoms such as coughing, wheezing, or dyspnea occur at the workplace. Its use is risky. A cook (28 years old) has been complaining of rhinoconjunctivitis and contact urticaria while preparing seafood for 3 years. He continues to work, now wears gloves, no longer tastes fish dishes, and receives anti-obstructive therapy (ICS, LABA). Methacholine (MCH) testing for bronchial hyperreactivity (BHR) shows mild BHR (PD100;sRaw: 0.28 mg MCH), skin and blood tests show type I sensitization to fish and crustacean proteins. In SIC with fried shrimps, rhinoconjunctivitis, coughing and distance wheezing, FEV1 drop > 20%, sRaw increase to 9.6 kPa*s and angioedema occur. Since routine tests showed only a moderate BHR, the suspicion of an occupational disease was formulated very late in the medical examination process. Only the SIC showed the severity of the cook’s bronchial asthma.
Author Details
Authors
Departments
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Address
PD Dr. med. Alexandra M. Preisser, Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, 20459 Hamburg, Germany
Email:
[email protected]
Citation
Alexandra M. Preisser, Alexander M. Kraft, and Volker Harth.Severe bronchial reaction to provocation with fish and crustaceans. 2020; 4: 118-123. doi: 10.5414/ALX02129E.
