Mäkinen-Kiljunen S, Mussalo-Rauhamaa H, Petman L, Rinne J, Haahtela T
Division of Allergology, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Allergy. 2001 Jul;56(7):696-700. doi: 10.1034/j.1398-9995.2001.00142.x.
Allergy to insects is common. However, few reports cover occupational sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). We describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth.
The skin prick test (SPT) and serum IgE tests were used to evaluate the patient's sensitivity to flour moth. Allergen cross-reactivity with mites was evaluated in IgE-inhibition studies. Clinical sensitivity was evaluated by nasal challenge test. Pulmonary function tests were repeatedly monitored.
SPT with flour moth gave a 6-mm wheal, and an elevated level of flour moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). Immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, and >86 kDa in the extract of flour moth. Allergen cross-reactivity with mites was demonstrated in inhibition studies. Immediate-type allergy to flour moth was confirmed by nasal challenge. Increased daily variability of PEF values was observed during workplace exposure.
A baker's occupational respiratory allergy to flour moth was confirmed.
昆虫过敏很常见。然而，关于职业性面粉蛾（粉斑螟[同义词：干果斑螟]）致敏的报道很少。我们描述了一名患有IgE介导的职业性面粉蛾呼吸道过敏的面包师。
采用皮肤点刺试验（SPT）和血清IgE检测评估患者对面粉蛾的敏感性。在IgE抑制研究中评估过敏原与螨虫的交叉反应性。通过鼻腔激发试验评估临床敏感性。反复监测肺功能测试。
面粉蛾皮肤点刺试验出现6毫米风团，患者血清中面粉蛾特异性IgE水平升高（1.9 PRU/ml，RAST 2级）。用患者血清进行免疫印迹显示，面粉蛾提取物中至少有七条重链IgE结合带，分子量分别为22、35、43、53、65、77和>86 kDa。抑制研究证明了过敏原与螨虫的交叉反应性。鼻腔激发试验证实了对面粉蛾的速发型过敏。在工作场所接触期间观察到呼气峰流速（PEF）值的每日变异性增加。
一名面包师的职业性面粉蛾呼吸道过敏得到确诊。
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