ABSTRACT
BACKGROUND: Occupational Asthma (OA) is a common disorder attributable to causes and conditions found in the workplace. Occupational asthma may have an immunologic or nonimmunologic basis and may be caused by several hundred agents. A number of factors may increase the risk of developing OA including genetic, industrial, meteorologic, social, and medical factors. METHODS: The diagnosis is best made by fulfilling well-defined clinical criteria by way of a meticulous and oftentimes arduous evaluation. Pre-existing asthma and allergy, along with other special variants of asthma and unrelated pulmonary disorders which can masquerade as asthma, must be ruled out. CONCLUSION: Convincing physiologic evidence that demonstrates a cause-and-effect relationship must be obtained before a definitive diagnosis of work-related asthma is made.
Subject(s)
Asthma/diagnosis , Occupational Diseases/diagnosis , Asthma/immunology , Diagnosis, Differential , Humans , Occupational Diseases/immunologyABSTRACT
Sensitization to HMW allergens is a relatively common immunopathogenic factor in occupational asthma. The mechanism of sensitization is an IgE-mediated, type I reaction. High molecular weight allergen refers to proteins and polymers of organic compounds over 5 kd and usually in the 20 to 50 kd range. In most cases diagnosis requires: 1. A high index of suspicion of job-related asthma. 2. Exposure to HMW compounds and clinical findings associated with such an exposure. 3. Confirmation of sensitization by appropriate in vitro or in vivo tests. 4. Confirmation of a pathogenic role by physiologic measurements in either a natural setting or during laboratory-controlled challenges.
Subject(s)
Allergens/adverse effects , Asthma/etiology , Occupational Diseases/etiology , Allergens/immunology , Asthma/diagnosis , Asthma/immunology , Humans , Medical History Taking , Molecular Weight , Occupational Diseases/diagnosis , Occupational Diseases/immunologyABSTRACT
An adolescent developed invasive pulmonary aspergillosis in the limited form of a lung abscess. She had a weak immunologic response to the infection. Her depressed immunity was the result of prolonged corticosteroid therapy, compounded by malnutrition. In spite of this and other complications of corticosteroids, she made a full recovery from the fungal infection following treatment with amphotericin B and surgical excision of the lung abscess.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Aspergillosis/etiology , Asthma/drug therapy , Lung Abscess/etiology , Nutrition Disorders/complications , Adolescent , Agammaglobulinemia/etiology , Aspergillosis/immunology , Female , Humans , Immunity, Cellular , Lung Abscess/immunologyABSTRACT
Nine asthmatic children were sensitive to a variety of antigens by skin testing and bronchial inhalation challenges. On two separate occasions they received the antigens sublingually at 2.5 to 50 times the dose received by bronchial challenge. There were no subjective symptoms or objective changes in pulmonary function measurements following the oral challenges.
