Abstract

A 44-year-old woman, non-smoker, with a clinical history of spring seasonal rhinoconjunctivitis and asthma. She had no family history of atopy. For the last 6 years, she had een working temporarily as instructor of personnel making dried flower arrangements (centrepieces and baskets). Since 5 months after her first contact with dried flowers of safflower and yarrow she began to experience rhinitis, asthma and urticaria symptoms in the workplace when she handled these dried flowers. The physical examination was normal. Basal spirometry and chest X-ray was normal. Methacholine inhalation test was positive with a PC20 of 2.5 mg/ml. Total
serum IgE was 7.94 kU/l. Skin prick test with common aeroallergens were positive to pollen from Cupressus sempervirens, Olea europaea, Lolium perenne, Salsola kali, Artemisia vulgaris and Parietaria judaica and to cat and dog epithelium. Skin prick test with aqueous extracts from dried flowers were positive to safflower (8 · 5 mm) and yarrow (10 · 7 mm). Specific Inhalation Bronchial Challenge with aqueous extract of safflower (0.625 mg/ml) and yarrow (1.25 mg/ml) elicited an asthmatic response
with a fall in FEV1 of 27% and 31% respectively. Specific IgE
(EAST) with safflower and yarrow flowers was 1.4 and 0, 9 kU/l respectively. Immunoblotting with safflower flowers revealed several IgE binding bands of 64,61, 47, 45, 41, 21, 18.6, and between 14–15 kDa and with yarrow flowers bands of 51, 21 and 18 kDa.
Occupational respiratory symptoms caused by decorative flowers are seldom
reported in the literature. Only two dried flowers (Limonium tataricum and Gypsophilia panniculata have been reported as a cause of allergic asthma.

Carthamus tinctorius L. (safflower) and Achillea millefolium L. (yarrow) belong to the Compositae family.

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Comments

Agent Dried flowers of yarrow (Achillea millefolium) and safflower (Carthamus tinctorius) Job Instructor of dried flower arrangers Proof IgE present to allergen extract Skin prick test present to allergen extract Non specific bronchial challenge present Serial peak flow records not done Specific Bronhial Challenge: immediate reaction to allergen extracts (no controls, very brief reactions) No follow up

4/18/2008