Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Italy.
Am J Ind Med. 2011 Jul;54(7):565-8. doi: 10.1002/ajim.20948. Epub 2011 Mar 10.
Occupational and environmental factors may be a cause of nonasthmatic eosinophilic bronchitis (NAEB). The diagnosis of occupational NAEB requires evidence of sputum eosinophilia. Nevertheless, a minority of patients are not able to produce suitable sputum specimens.
This case report describes a 25-year-old woman, working as a hairdresser since the age of 20 years and handling ammonium persulfate, who came under our observation for work-related rhinitis and cough.
A specific inhalation challenge with ammonium persulfate elicited dry cough, without any significant change in forced expiratory volume in 1 s (FEV(1) ). Sputum induction was unsuccessful both pre- and after specific inhalation challenge. Fractional exhaled nitric oxide (FeNO) values significantly increased after specific inhalation challenge, suggesting a diagnosis of occupational NAEB due to ammonium persulfate.
From this observation we suggest that FeNO measurement should be added to the investigation of work-related cough during specific inhalation challenge, and may be considered as an alternative to induced sputum to evaluate bronchial inflammation when sputum collection is unavailable or unsuccessful.
职业和环境因素可能是导致非哮喘性嗜酸性粒细胞性支气管炎（NAEB）的原因。职业性 NAEB 的诊断需要痰嗜酸性粒细胞增多的证据。然而，少数患者无法产生合适的痰标本。
本病例报告描述了一位 25 岁的女性，自 20 岁起从事理发师工作，接触过过硫酸铵，因工作相关的鼻炎和咳嗽而接受我们的观察。
过硫酸铵特异性吸入激发引起干咳，1 秒用力呼气容积（FEV1）无明显变化。特异性吸入激发前后均未能成功诱导痰。特异性吸入激发后，呼出气中一氧化氮分数（FeNO）值显著升高，提示诊断为过硫酸铵引起的职业性 NAEB。
从这次观察中，我们建议在特异性吸入激发期间，应将 FeNO 测量值添加到与工作相关的咳嗽调查中，并且当无法或无法成功收集痰时，可考虑作为评估支气管炎症的替代方法，以替代诱导痰。
