Occupational asthma from cheese making; new cause

This is a case report of occupational asthma in a cheesemaker. Cheese making requires rennet for milk curdling, traditionally extracted from calf stomachs. Due to a scarcity of calf stomachs, other sources are being used from animals, plants and microbes. Despite this the cause in this case was calf chymotrypsin (part of rennet). Intradermal tests to calf chymotrypsin 1:1000 w/v were being used "to calculate the rennet concentration at which to start the bronchial provocation test". This induced a severe asthmatic reaction requiring im adrenalin, iv methyl prednisolone and polaramine. Unfortunately no lung function measures were made. This report identifies cheesemaking as a cause of occupational asthma as well as hypersensitivity pneumonitis, identifies changes in the process of cheesemaking and shows the dangers of intradermal skin prick testing without (at least first) doing skin prick tests with more dilute antigen

References

	Torrijos G, Rodriguez G, Perez V, Bartolome, Barragan P, Occupational allergic respiratory disease (rinoconjunctivitis and asthma) in a cheese factory worker, Journal of Allergy and Clinical Immunology: In Pra, 2018;6:1416-1418,

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