Pontier J-P, Popin E, Kopferschmitt-Kubler M-C, Bessot J-C, Pauli G
Service de Pneumologie-Médecine 2, Centre Hospitalier, 4, rue Godard-Jeanson, 52115 Saint-Dizier.
Rev Pneumol Clin. 2002 Nov;58(5 Pt 1):282-5.
We report the case of a 28-year old man suffering from rhinitis and asthma which appeared 8 years after exposure to different woods, especially abachi wood. Serial PEFR monitoring at work and away from work were consistent with occupational asthma. Spirometry showed an airway obstruction, and metacholine inhalation test was positive. Skin prick-tests performed with different woods were only positive to abachi wood extract. The search for specific IgE was positive to abachi wood (4, 98 KU/l, class 3). The diagnosis of occupational asthma caused by exposure to abachi wood was established, the mechanism underlying this asthma was IgE mediated. Despite respiratory protection measures, the patient had persisting symptoms and was laid off. The German service for social cover asked for an expert evaluation: specific nasal and inhalation provocation tests performed by exposure to fine abachi wood dust were positive. This is an observation with a double significance: first, although the mechanisms underlying wood occupational asthma remain largely unknown, an IgE mechanism for abachi wood was demonstrated; second, legislation is different in France and Germany where occupational asthma will only be acknowledged if inhalation tests are positive.
我们报告了一名28岁男性的病例，他在接触不同木材，尤其是阿巴奇木8年后出现了鼻炎和哮喘。在工作时和非工作时进行的连续呼气峰流速（PEFR）监测结果与职业性哮喘相符。肺功能测定显示气道阻塞，乙酰甲胆碱吸入试验呈阳性。用不同木材进行的皮肤点刺试验仅对阿巴奇木提取物呈阳性。特异性IgE检测对阿巴奇木呈阳性（4, 98 KU/l，3级）。确诊为由接触阿巴奇木引起的职业性哮喘，该哮喘的潜在机制为IgE介导。尽管采取了呼吸防护措施，患者仍有持续症状并被解雇。德国社会保障部门要求进行专家评估：通过接触阿巴奇木细粉尘进行的特异性鼻腔和吸入激发试验呈阳性。这是一个具有双重意义的观察结果：第一，尽管木材职业性哮喘的潜在机制在很大程度上仍不清楚，但已证明阿巴奇木存在IgE机制；第二，法国和德国的立法不同，在德国只有吸入试验呈阳性时才会承认职业性哮喘。
