Yeni Bir Mesleksel Astma Nedeni: Rhizoma Zingiberis

Abstract

A New Etiology of Occupational Asthma A 28-year-old woman who has been working in a drug factory in Samsun for 10 years, during which she had worked at packing within first 5 years and is still working at manufacture department for 5 years, presented with a history of attacks of itching of throat, cough and dyspnea at workplace for 2 years. Occupational asthma was initial diagnosis and she was evaluated for confirmation of the diagnosis. Physical examination was normal, and also was pulmonary function test. Serum total IgE was 1268 IU/ml. Skin tests and bronchial provacation tests with polivinyl pirrolidon-iodur complex (Batticon®), dimenhidrinat (Anti EM®), and Rhizoma zingiberis (Ginger®) that all were manufactured at her workplace were done. Skin test with Rhizoma zingiberis was positive with 8x8 mm of which negative control was was 2x2 mm and histamine was 5x5 mm. Bronchial provacation tests with Rhizoma zingiberis was also positive and its results were as follows: initial FEVI: 2,97 L/min, FEVI at 5th minute: 1.20 L/min (58% of initial value). The results of bronchial provacation tests and also skin tests with common allergens and the other two drugs to which she exposed during working were negative. To our knowledge, our case is the first case that reports Rhizoma zingiberis as an etiologic agent for occupational asthma. Samsun'daki bir ilaç fabrikasında 10 yıldır (5 yıl paketleme, son 5 yıl imalat bölümü) çalışan son 2 yıldır boğazında ve kulaklarında kaşınb, şiddetli öksürük ve takiben nefes darlığı atakları tanımlayan, iş yerinde şikayetleri belirgin olarak artan 28 yaşındaki kadın hasta mesleksel astma düşünülerek incelemeye alındı. Fizik muayenede bir özellik yoktu. Solunum fonksiyon testleri normal, serum total IgE: 1268 iü/ml idi. Çalıştığı bölümde imalatı yapıları polivinil pirrolidon iyot kompleksi (Batticon®) dimenhidrinat (Anti EM®) ve Rhizoma zingiberis (Ginger®) ile deri ve bronkoprovakasyon testleri yapıldı. Rhizoma zingiberis ile deri tesü pozitif (RZ: 8 x 8mm, negatif konrol : 2 x 2 mm, histamin: 5x5 mm) bulunurken, aynı antijenle FEVı de %58 lik düşme (FEVI başlangıçta 2,97 L , 5. dakikada 1.20 L) saptandı. 15' adet yaygın antijenle deri testleri ve diğer iki ilaçla yapılan deri ve bronkoprovakasyon testleri negatif idi. Kaynaklarda Rhizoma zingiberis ile oluşan mesleksel astmaya rastlayamadık. Vakamız Rhizoma zingiberis'in yeni bir mesleksel astma nedeni olabileceğini düşündürmektedir.

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