Merget Rolf, Raulf Monika, Sander Ingrid
Institute for Prevention und Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Germany.
Allergol Select. 2021 Jan 26;5:77-81. doi: 10.5414/ALX02131E. eCollection 2021.
A 58-year-old non-atopic chemical worker complained about work-related asthma and rhinoconjunctivitis about 4 years after exposure to quillaja bark and soapnut. Bronchial hyperresponsiveness was demonstrated after withdrawal of medication for 12 hours. Skin prick tests with extracts from quillaja bark and soapnut from the workplace were positive, but ImmunoCAP was positive only with quillaja bark, probably due to the low protein content of the extract from soapnut. Sensitizations to quillaja bark and soapnut, but not to saponin were demonstrated by immunoblot. An inhalation test with a dosimeter was positive with the soapnut extract. A link between disease and exposure was documented by serial measurements of exhaled nitric oxide at and off work, despite preventive measures. A diagnosis of occupational allergy due to quillaja bark and soapnut was made. Further exposure reduction was recommended.
一名58岁的非特应性化工工人在接触皂树皮和无患子约4年后，抱怨患有与工作相关的哮喘和鼻结膜炎。停药12小时后显示出支气管高反应性。对工作场所的皂树皮和无患子提取物进行的皮肤点刺试验呈阳性，但ImmunoCAP仅对皂树皮呈阳性，可能是由于无患子提取物的蛋白质含量低。免疫印迹显示对皂树皮和无患子致敏，但对皂苷不致敏。用剂量仪进行的吸入试验对无患子提取物呈阳性。尽管采取了预防措施，但通过在工作时和下班后连续测量呼出一氧化氮，记录了疾病与接触之间的联系。诊断为皂树皮和无患子引起的职业性过敏。建议进一步减少接触。
