Background
Occupational asthma is a well studied pathology and the identification of the causal agent is essential for a correct diagnosis. We describe one case of occupational asthma due to a new allergen that has not been yet published.
Case report
A 40-year-old woman is working in a tea shop for 5 years. Since one year, she referred cough, dyspnea and wheezing when she was exposed to a tea with ginger. Six months before she was started with rhinitis symptoms in work place.
Methods
Skin prick test was performed with batteries of aeroallergen and spices, green, red and black teas, and a own ginger extract at 8.5 mg/ml. Specific serum IgE to ginger and tea was determined by CAP system Pharmacia. Methacholine bronchial challenge and peak-flow monitoring was performed in working and holiday periods. Bronchial challenge with ginger extract (ALK-Abelló, Spain) was performed with exhaled nitric oxide (FeNO), FEV1 and PEF monitoring. SDS-PAGE and SDS-PAGE Immunobloting was performed with the ginger extract and serum from this patient.
Results
Skin prick test with batteries of aeroallergen and spices, green, red and black teas were negatives. Skin prick test con ginger extract was positive in our patient and negative in 4 control individuals. Specific IgE to tea was <0.35 KU/l and to ginger was 74 KU/l. Methacholine bronchial challenge in working and holiday periods, was positive (PC20, 6.58 mg/ml) and negative, respectively. Peak-flow register in working and holiday periods no showed significant differences (decreases). Bronchial challenge with ginger extract was positive at 1/100 diluted extract with immediate and late responses. No significant differences in FeNO were detected before and after specific bronchial challenge. IgE-Immunobloting showed different bands between 40 kD and 17 kD and one band between 7 and 10 kD.
Conclusions
We present a case of occupational asthma and rhinitis due to ginger exposition. To our knowledge, this is the first case reported in the literature.