A case of occupational gout

Gout can occur in any joint but most commonly afflicts the first metatarsophalangeal joint. Many theories have been suggested as explanations for this preferential joint involvement. We describe a case of gout occurring in the fingers of a man with occupational cold exposure, a case of "occupational" gout, and support for the involvement of temperature in acute attacks of gout.     

A case of occupational rhinitis caused by porcine pancreatic extract developing into occupational asthma

Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of alpha-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete.     

Model of experimental pollinosis

A model of experimental pollinosis was created in guinea pigs. The animals were kept in a chamber in which the allergen, a dialyzed aqueous extract of ragweed pollen, was dispersed by means of a coaxial nebulizer. As a result of aerosol sensitization the guinea pigs formed homocytotropic antibodies, an indication of their sensitization to the specific allergen. Sensitization of the animals to ragweed allergen was accompanied by increased sensitivity of the bronchopulmonary system and was characterized by reflex bronchospasm to a reacting inhalation or to intravenous injection of the specific allergen.Allergologic Research Laboratory, Academy of Medical Sciences of the USSR, Moscow. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 84, No. 11, pp. 590–593, November, 1977.     

Diagnosis of parietaria pollinosis

A prospective study of 54 patients showed that pollinosis due to parietaria is prevalent in Spain and frequently causes asthma and rhinitis. Because of its atypical clinical features, patients are often erroneously thought to have intrinsic asthma. False negative skin tests may occur, probably related to the type of extract used. This may contribute to a faulty diagnosis. The RAST is most useful for diagnosis.     

Winter pollinosis in Paris

Pollen is rarely investigated as a cause of winter respiratory symptoms. Infectious coryza and asthma are particularly common during winter, and it has been shown that environmental antigens can cause at least some cases in Paris. Recent experimental data with from Calhoun et al. (1991) indicate that pollen may act synergistically with viral respiratory infections, which are particularly prevalent in winter. In the present study, we investigated, in 130 consecutive patients presenting with winter aggravation of asthma or rhinitis, winter pollinosis by skin test, radioallergosorbent test (RAST), and specific endonasal challenge test. Totals of 35, 24, and 21 patients reacted positively in skin, RAST (> 0.70 PRU/ml), and endonasal tests, respectively. Clinical features during the season established the diagnosis of winter pollinosis in 20 cases; it was due to alder pollen in 10 patients and hazel pollen in 12. The positive predictive value of the skin test was only 0.57, as compared with 0.86 for the specific endonasal test, which had a negative predictive value of 1. Our results indicate that hazel and alder pollens should be prick-tested for more often as causes of winter respiratory symptoms in Paris, even if similar manifestations were absent during previous winters, were previously present during spring or summer, or were both absent in previous winters and present in spring or summer.     

Chrysanthemum pollinosis in Japan.

Using the scratch test with self-made chrysanthemum pollen extract of 32,700 PNU/ml, a positive response was elicited in 60 of 316 patients (18.9%) with allergic rhinitis and bronchial asthma, and was positive in 42.5% adults with allergic rhinitis. On the other hand a 4.7% positive response was obtained in 84 non-allergic subjects. With the intracutaneous test, a threshold value was determined in 7 cases with 0.327 PNU/ml; 12 with 3.27 PNU/ml; 8 with 32.7 PNU/ml; and 8 with 327 PNU/ml, as opposed to one positive in 84 controls with 327 PNU/ml (1.3%). P-K tests were successfully done in 15 out of 16 cases. Furthermore, the results of in vitro neutralization tests using chrysanthemum and other compositae pollen extracts indicated the absence of sharing antigenic determinants between them. Provocation tests were conducted in 4 cases of allergic rhinitis and 3 cases of bronchial asthma with positive response in all the patients. From these results it was found that chrysanthemim pollinosis indeed exists in Japan, particularly in the mountainous districts.     

Parietaria pollinosis: a review

Species of the genus Parietaria (pellitory) are a prevalent cause of allergy in the Mediterranean area and the most important in some European regions such as southern Italy and coastal Spain (14, 26, 27, 29, 30, 31, 36, 59, 69). Up to now, however, Parietaria has received little attention in northern Europe and the US because of its limited regional distribution. Therefore, less is known about Parietaria allergy than about other inhalant allergens such as those of grasses, ragweed, and mites. During the last 5 years, only 31 reports on Parietaria allergy have appeared in the literature, as compared with 37 papers on birch pollen. This ratio may appear unbalanced, considering that millions of people suffer from pollinosis caused by Parietaria, while a much smaller number have rhinitis and/or asthma caused by birch pollen. The increasing movement of people throughout Europe and to and from the US is reason to broaden our knowledge of patterns of inhalant allergy in each geographic area, especially where tourism and immigration are high. This paper briefly reviews available data and personal studies on the botanical, aerobiological, immunochemical, and clinical features of Parietaria allergy.