The case of TDI-induced reactive airway dysfunction syndrome with the presence of specific IgE antibodies.

Reactive Airways Dysfunction Syndrome defines a chronic, nonallergic bronchoconstriction syndrome due to a brief, single inhalation exposure to highly concentrated irritant factors. Here we describe a case history of RADS in patient exposed to isocyanates with the presence of specific IgE antibodies. According to some authors only RAST ratio > 2.0 is a criterion of an allergic origin or TDI-induced respiratory disease, and a lower ratio is believed to be a proof only of an exposure. Negative effects of bronchial specific provocative tests confirmed the insignificance of the IgE-mediated mechanism in RADS and on the other side emphasized the possibility of incorrect diagnosis of TDI-induced bronchospastic syndromes.