Occupational asthma and rhinoconjunctivitis from inhalation of crystalline bovine serum albumin powder.

A 24-year-old white female laboratory technician developed recurrent rhinoconjunctivitis and wheezing immediately following repeated exposure to purified lyophilized bovine serum albumin (BSA). Prick and titrated intradermal skin tests revealed strongly positive results in the patient and negative results in normal controls. A titrated double-blind, placebo-controlled bronchial inhalation challenge with an aqueous BSA solution was positive at 10 mg/mL. Use of an albuterol metered dose inhaler and avoidance of laboratory exposure to BSA have resulted in resolution of symptoms. These results are consistent with an IgE-mediated mechanism, and this case represents the first reported instance of occupational asthma and rhinoconjunctivitis to inhaled BSA powder.