Occupational Asthma Reference

Walusiak J, Wittczak T, Ruta U, Palczynsk C, Occupational asthma due to mitoxantrone, Allergy, 2002;57:461,

Keywords: new cause, mitoxandrone, Poland, challenge, BAL, NSBR,

Known Authors

Jolanta Walusiak, Lodz Jolanta Walusiak

If you would like to become a known author and have your picture displayed along with your papers then please get in touch from the contact page. Known authors can choose to receive emails when their papers receive comments.

Abstract

Occupational allergy due to cytostatics are scarce and mainly concern allergic contact dermatitis and allergic contact urticaria (1,2). To our knowledge, there is no published case report on mitoxantrone-induced allergic asthma. We present the case of a 41-year-old nurse who had worked
for 13 years in an oncology ward with exposure to antineoplastic drugs. For three years she had suffered from rhinorrhea, dyspnea and cough attacks, occurring 1–2 h after beginning work. For the first two years the patient presented only work-related symptoms; in the third year she developed
dyspnea also away from work. Clinical examinations, as well as routine
laboratory parameters, remained normal. The total IgE (CAP System, Pharmacia, Sweden) level was low (4.89 km/l). No specific IgE antibodies against latex, disinfectants and b-lactams were detected. Also skin prick tests to common allergens, latex (Allergopharma, Germany) chloramine and chlorhexidine (0.001, 0.01 and 0.1% solutions) were negative. The histamine provocation test showed unremarkable bronchial hyperreactivity (PC20=0.093 mg/ml). The patient was subjected to a number of single-blind bronchial challenge tests with subsequent cytostatics monitored by spirometry and
peak expiratory flow (PEFR) measurements.

The provocation with mitoxantrone induced a 15% fall in forced expiratory volume (FEV1) at 1 h, with a 20% decrease 4 h later. One week later the
challenge with mitoxantrone was repeated. Bronchoalveolar lavage fluid (BAL) was taken before and at 6 and 18 h after the provocation. Significant increase in lymphocytes and neutrophil proportion was observed, especially at 18 h after the challenge. We also noted eosinophil influx, up to 4%, and more than a two-fold increase (from 8.0% before to 18.2%) in the permeability index. The same provocation test was performed in an asthmatic volunteer not exposed to antineoplastic drugs. There were no significant changes in cell proportions apart from a slight increase in neutrophils
(from 1% to 6% at 18 h).

Plain text: Occupational allergy due to cytostatics are scarce and mainly concern allergic contact dermatitis and allergic contact urticaria (1,2). To our knowledge, there is no published case report on mitoxantrone-induced allergic asthma. We present the case of a 41-year-old nurse who had worked for 13 years in an oncology ward with exposure to antineoplastic drugs. For three years she had suffered from rhinorrhea, dyspnea and cough attacks, occurring 1-2 h after beginning work. For the first two years the patient presented only work-related symptoms; in the third year she developed dyspnea also away from work. Clinical examinations, as well as routine laboratory parameters, remained normal. The total IgE (CAP System, Pharmacia, Sweden) level was low (4.89 km/l). No specific IgE antibodies against latex, disinfectants and b-lactams were detected. Also skin prick tests to common allergens, latex (Allergopharma, Germany) chloramine and chlorhexidine (0.001, 0.01 and 0.1% solutions) were negative. The histamine provocation test showed unremarkable bronchial hyperreactivity (PC20=0.093 mg/ml). The patient was subjected to a number of single-blind bronchial challenge tests with subsequent cytostatics monitored by spirometry and peak expiratory flow (PEFR) measurements. The provocation with mitoxantrone induced a 15% fall in forced expiratory volume (FEV1) at 1 h, with a 20% decrease 4 h later. One week later the challenge with mitoxantrone was repeated. Bronchoalveolar lavage fluid (BAL) was taken before and at 6 and 18 h after the provocation. Significant increase in lymphocytes and neutrophil proportion was observed, especially at 18 h after the challenge. We also noted eosinophil influx, up to 4%, and more than a two-fold increase (from 8.0% before to 18.2%) in the permeability index. The same provocation test was performed in an asthmatic volunteer not exposed to antineoplastic drugs. There were no significant changes in cell proportions apart from a slight increase in neutrophils (from 1% to 6% at 18 h).

Full Text

Full text of this reference not available

Please Log In or Register to add the full text to this reference

Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

Which agents cause occupational asthma and which workers are at risk?
burgeps mitoxantrone caused occupational asthma with latency in an oncology nurse with positive specific challenge

Please Log In or Register to put forward this reference as evidence to a question.

Comments

Please sign in or register to add your thoughts.


Oasys and occupational asthma smoke logo