Institute of the Ruhr-University, Bochum, Germany.
Adv Exp Med Biol. 2013;755:47-53. doi: 10.1007/978-94-007-4546-9_6.
Allergic immediate-type reactions by halogenated compounds of platinum (Pt) (platinum salts) have been described in workers in precious metal refineries and catalyst productions. In both industries there are exposures to many different Pt compounds. It is believed that the most important allergens are those compounds with the highest number of halide ligands. It is unknown whether sensitizations to compounds with a lower number of halide ligands represent co-sensitizations or are due to cross-reactivity. We report a worker engaged in the production of cytotoxic drugs with occupational asthma and exposure to only one Pt salt with four halide ligands. The 22-year-old worker developed work-related sneezing, runny nose, and variable dyspnea about a year after he had started to work in the cytotoxic drugs production with exposure to potassium tetrachloroplatinate(II) (K(2)PtCl(4)). He was immediately removed from his workplace and admitted for a medical opinion about 6 months afterwards. Spirometry was normal, but asthma was corroborated by a positive response to methacholine. The results of skin prick testing could not be interpreted due to urticaria factitia. Challenge with K(2)PtCl(4) by a dosimeter method yielded a clear immediate-type reaction with an increase of exhaled nitric oxide from 32 to 156 ppb after 24 h indicating an increased airway inflammation. Pt salts with four halide ligands like K(2)PtCl(4) may cause an allergic immediate-type reaction and occupational asthma. Workers in the production of Pt-containing cytotoxic drugs with exposure to these substances should be included in medical surveillance programs for the prevention of occupational asthma caused by Pt salts.
含卤素的铂化合物（铂盐）引起的过敏即刻型反应在贵金属精炼厂和催化剂生产工人中已有描述。在这两个行业中，工人会接触到许多不同的 Pt 化合物。人们认为最重要的过敏原是那些具有最高数量卤化物配体的化合物。对于具有较低数量卤化物配体的化合物的致敏作用是代表共同致敏还是由于交叉反应，目前尚不清楚。我们报告了一名从事细胞毒性药物生产的工人，他患有职业性哮喘，并且仅接触过一种带四个卤化物配体的 Pt 盐。这名 22 岁的工人在开始接触四氯铂酸钾（K2PtCl4）生产细胞毒性药物后大约一年出现与工作相关的打喷嚏、流鼻涕和多变性呼吸困难。他立即从工作场所撤离，并在大约 6 个月后接受了医疗意见。肺量测定正常，但乙酰甲胆碱激发试验呈阳性，证实存在哮喘。由于出现人工荨麻疹，皮肤点刺试验的结果无法解释。通过剂量计法进行 K2PtCl4 激发试验，在 24 小时后，呼气一氧化氮从 32 增加到 156 ppb，表明气道炎症增加，出现明确的即刻型反应。像 K2PtCl4 这样带四个卤化物配体的 Pt 盐可能会引起过敏即刻型反应和职业性哮喘。接触这些物质的含 Pt 细胞毒性药物生产工人应纳入医疗监测计划，以预防由 Pt 盐引起的职业性哮喘。
