Cockroach asthma: case report and literature review.

Among the different antigens, insects play an important role in the induction of allergic reactions. We report on a 12-year-old boy with family history of atopy, who developed symptoms of rhinitis and perennial asthma since the age of 5. Patient's symptomatology increased during pollination and kept close relationship to domestic antigens. A skin and inhalation test with an extract of domestic dust was positive. An investigation about potential allergens was initiated and the patient mentioned that was a significant amount of cockroaches at his home. Skin tests, RAST and bronchial provocative tests with a cockroach extract gave positive results. Bronchial provocative tests with a cockroach extract gave immediate and late responses, as has been evidenced by different authors. Immunotherapy has been successfully employed, partly due to the difficulties inherent to an efficient way of preventing insect contact. Improvement of symptomatology correlates well with blocking antibody production and the reduction in white cell sensitivity to the antigenic system. Finally, the potential relevance of cockroach hypersensitivity in our country be underlined. Cockroach sensitivity should be considered in every patient with perennial asthma, in which the usual allergens have been excluded.