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Sensitization to Domestic Mites in Santo Domingo (The Caribbean)
Abstracts S235
J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2
A Cluster of Cases of Cutaneous Rashes in Swimmers Exposed to Freshwater Spring-fed Rivers in Northern Florida D. F. McMahon1, S. M. Watkins2, A. R. Reich3, D. A. Kellogg1, B. E. Gonzalez4, J. W. Sleasman1; 1University of South Florida, St. Petersburg, FL, 2Florida Department of Health, Tallahassee, FL, 3University of Florida, Tallahassee, FL, 4The Children’s Hospital of S.W. Florida, Ft. Myers, FL. RATIONALE: Cutaneous skin rashes have been associated with toxins elaborated by marine microorganisms but are uncommonly associated with water from fresh water springs. We report a cluster of individuals who developed erythematous rashes following swimming in a spring-fed freshwater river in Northern Florida. METHODS: A retrospective review of medical records, personal interviews, and examination of skin biopsy results of affected individuals was performed. Four individuals developed pruritic, erythematous, papular rashes within 2 days of swimming together in the same spring-fed river. Two other swimmers in their group who bathed with soap following swimming did not develop rash. RESULTS: One of the swimmers, a 15 year old Hispanic female, developed rash that began as small pruritric papules over the thighs, arms, back, and axilla. The lesions persisted for more than three weeks. Laboratory findings included blood eosinophillia (13%) but not other cause for the rash could be identified including a negative stool ova and parasite exam. Skin biopsy of the lesions showed mixed perivascular inflammatory infiltrate with lymphocytes and eosinophils, as well as epidermal hyperkerotosis. Stains for fungal and acid fast organisms were negative. The rash slowly resolved after four weeks. CONCLUSIONS: Several cyanobacteria species have been recently isolated from Florida’s fresh water springs including Lyngbya wollei and Oscillatoria species. These organisms are known to elaborate toxins such as saxitoxin, microcystin, debromoaplysiatoxin, and cylindrospermopsin. It is likely that cutaneous exposure to these toxins resulted in the rashes seen in our patients. This is the first reported case characterizing rashs to exposure to fresh water springs.
908
Serum Eosinophil Cationic Protein, a Useful Follow-up Marker in Baker's Asthma H. Kang1, S. Sohn2, J. Kim1, S. Park1, Y. Hwang1, S. Jang1, D. Kim1, K. Jung1; 1Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Republic of Korea, 2Department of Internal Medicine, Dongguk University International Hospital, Goyang-si, Republic of Korea. RATIONALE: The first step in the treatment of occupational asthma is complete avoidance from causative agents. Because of difficulty in re-employment, job relocation within the same company is preferred rather than complete career change. We hypothesized that eosinophil cationic protein (ECP) can be a useful simple substitute on evaluating the effectiveness of job relocation instead of a laborious methcholine bronchial provocation test. METHODS: Follow-up methacholine test was carried out to assess airway hyperresponsiveness (AHR) in 12 workers confirmed as baker’s asthma after 6-month job relocation. Skin prick test with wheat flour, ELISA for flour-specific IgE, and measurement of sputum and serum ECP by immunoCAPÒ method were done to evaluate the status of allergic inflammation. RESULTS: All 12 workers showed improvement in symptom and AHR. Eight workers became symptom-free and exhibited negative conversion on methacholine test. Only half of the workers revealed decreased skin reactivity or serum flour-specific IgE level. While sputum ECP levels were quite variable (23;909 ng/mL) and not completely compatible with AHR improvement (9 of 12), serum ECP levels were less variable (2.79;36.2 ng/mL) and more consistent with AHR improvement (12 of 12). CONCLUSIONS: Serum ECP measurement can be a useful tool for evaluating the appropriateness of job relocation in baker’s asthma.
909
A Change of the Sensitization Rate to the House Dust Mite of Pediatric Allergic disease in Busan during Recent Five Years J. Jung1, J. Lee2, J. Kim3, J. Kim1, Y. Chung4; 1Dong-A University Medical center, Busan, Republic of Korea, 2Masan Samsung Hospital, Masan, Republic of Korea, 3Ulsan University Hospital, Ulsan, Republic of Korea, 4 Good Gang-An Hospital, Busan, Republic of Korea. RATIONALE: House dust mite (HDM) is one of the most important causes in pediatric allergic diseases. However, there is few reports about the sensitization rate to HDM of pediatric allergic disease in Busan. We evaluated the differences in the sensitization rates to HDM between 2002 and 2007. METHODS: Four hundred fifteen patients who visited pediatric department in Dong-A medical center with bronchial asthma, allergic rhinitis and atopic dermatitis during 2002 (n 5 201) and 2007 (n 5 215) were enrolled. We reviewed medical records retrospectively to determine serum total eosinophil count (TEC), total IgE and specific IgE to HDM (Dp, Df). RESULTS: The sensitization rate to Dp and Df were slightly decreased in 2007 than in 2002. (P > 0.05) According to age, sensitization rate to Dp in patients who were from 2 to 3 years old was significantly decreased in 2007 than in 2002. (P 5 0.04) According to diagnosis, sensitization rate to Dp in patients who has asthma alone was significantly decreased in 2007 than in 2002. (P 5 0.03) The sensitization rate to Df in patients who has asthma alone and asthma with allergic rhinitis were significantly decreased in 2007 than in 2002. (P 5 0.03) CONCLUSIONS: The sensitization rate to the house dust mite in Busan was decreased in 2007 than in 2002, especially at 2-3 ages, asthma with allergic rhinitis. This results could be associated with prevalence of allergic disease in Busan and I suggest multicenter studies in local area to assess the sensitization rate to other allergens.
910
Sensitization to Domestic Mites in Santo Domingo (The Caribbean) A. J. Castillo1, E. Fernandez-Caldas2, H. Barata3; 1Allergy and Asthma Center, Santo Domingo, Dominican Republic, 2Allergy Innovations GmbH; R&D Department, Starnberg, Germany, 3Laboratorios Diater, R&D Department, Buenos Aires, Argentina. RATIONALE: Mite allergy is common in the Caribbean and, in general, in the tropics. The objective of this study was to establish the rate of sensitization to 9 mite species in consecutive allergic patients evaluated at an outpatient clinic in Santo Domingo, where to the best of our knowledge, no studies are available on mite sensitivity. METHOD: Sixty consecutive patients (51.6 females) (mean age 30.5 years; 3-67) with asthma and/or allergic rhinoconjunctivitis were skin tested with commercial extracts of the following mite species: Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis, B. kulagini, Acarus siro, Lepidoglyphus destructor, Tyropahgus putrescentiae, Glycyphagus domesticus and Chortoglyphus arcuatus. Other allergens included: dog, cat, molds, grasses, trees and weeds. A skin test was considered positive when the wheal was > 3 mm with erythema. Conventional exclusion criteria were used. RESULTS: A positive skin test to any of the allergens tested was detected in 98.3% of the patients; 98.3% reacted to at least 1 mite species; 10% were exclusively positive to Dermatophagoides spp.; 8% were exclusively positive to non-Dermatophagoides spp.; 80% reacted to Blomia spp. and 5% were exclusively positive to B. tropicalis; 78% were sensitized to 3 or more mite species. CONCLUSIONS: There is a high prevalence of skin test sensitivity to mite species in allergic patients in Santo Domingo. Sensitization to several species is common. B. tropicalis is an important species in this region. Future studies will compare these results with the mite fauna in houses in Dominican Republic and evaluate cross reactivity of all these mite species.
TUESDAY
907
J ALLERGY CLIN IMMUNOL VOLUME 123, NUMBER 2
A Cluster of Cases of Cutaneous Rashes in Swimmers Exposed to Freshwater Spring-fed Rivers in Northern Florida D. F. McMahon1, S. M. Watkins2, A. R. Reich3, D. A. Kellogg1, B. E. Gonzalez4, J. W. Sleasman1; 1University of South Florida, St. Petersburg, FL, 2Florida Department of Health, Tallahassee, FL, 3University of Florida, Tallahassee, FL, 4The Children’s Hospital of S.W. Florida, Ft. Myers, FL. RATIONALE: Cutaneous skin rashes have been associated with toxins elaborated by marine microorganisms but are uncommonly associated with water from fresh water springs. We report a cluster of individuals who developed erythematous rashes following swimming in a spring-fed freshwater river in Northern Florida. METHODS: A retrospective review of medical records, personal interviews, and examination of skin biopsy results of affected individuals was performed. Four individuals developed pruritic, erythematous, papular rashes within 2 days of swimming together in the same spring-fed river. Two other swimmers in their group who bathed with soap following swimming did not develop rash. RESULTS: One of the swimmers, a 15 year old Hispanic female, developed rash that began as small pruritric papules over the thighs, arms, back, and axilla. The lesions persisted for more than three weeks. Laboratory findings included blood eosinophillia (13%) but not other cause for the rash could be identified including a negative stool ova and parasite exam. Skin biopsy of the lesions showed mixed perivascular inflammatory infiltrate with lymphocytes and eosinophils, as well as epidermal hyperkerotosis. Stains for fungal and acid fast organisms were negative. The rash slowly resolved after four weeks. CONCLUSIONS: Several cyanobacteria species have been recently isolated from Florida’s fresh water springs including Lyngbya wollei and Oscillatoria species. These organisms are known to elaborate toxins such as saxitoxin, microcystin, debromoaplysiatoxin, and cylindrospermopsin. It is likely that cutaneous exposure to these toxins resulted in the rashes seen in our patients. This is the first reported case characterizing rashs to exposure to fresh water springs.
908
Serum Eosinophil Cationic Protein, a Useful Follow-up Marker in Baker's Asthma H. Kang1, S. Sohn2, J. Kim1, S. Park1, Y. Hwang1, S. Jang1, D. Kim1, K. Jung1; 1Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Republic of Korea, 2Department of Internal Medicine, Dongguk University International Hospital, Goyang-si, Republic of Korea. RATIONALE: The first step in the treatment of occupational asthma is complete avoidance from causative agents. Because of difficulty in re-employment, job relocation within the same company is preferred rather than complete career change. We hypothesized that eosinophil cationic protein (ECP) can be a useful simple substitute on evaluating the effectiveness of job relocation instead of a laborious methcholine bronchial provocation test. METHODS: Follow-up methacholine test was carried out to assess airway hyperresponsiveness (AHR) in 12 workers confirmed as baker’s asthma after 6-month job relocation. Skin prick test with wheat flour, ELISA for flour-specific IgE, and measurement of sputum and serum ECP by immunoCAPÒ method were done to evaluate the status of allergic inflammation. RESULTS: All 12 workers showed improvement in symptom and AHR. Eight workers became symptom-free and exhibited negative conversion on methacholine test. Only half of the workers revealed decreased skin reactivity or serum flour-specific IgE level. While sputum ECP levels were quite variable (23;909 ng/mL) and not completely compatible with AHR improvement (9 of 12), serum ECP levels were less variable (2.79;36.2 ng/mL) and more consistent with AHR improvement (12 of 12). CONCLUSIONS: Serum ECP measurement can be a useful tool for evaluating the appropriateness of job relocation in baker’s asthma.
909
A Change of the Sensitization Rate to the House Dust Mite of Pediatric Allergic disease in Busan during Recent Five Years J. Jung1, J. Lee2, J. Kim3, J. Kim1, Y. Chung4; 1Dong-A University Medical center, Busan, Republic of Korea, 2Masan Samsung Hospital, Masan, Republic of Korea, 3Ulsan University Hospital, Ulsan, Republic of Korea, 4 Good Gang-An Hospital, Busan, Republic of Korea. RATIONALE: House dust mite (HDM) is one of the most important causes in pediatric allergic diseases. However, there is few reports about the sensitization rate to HDM of pediatric allergic disease in Busan. We evaluated the differences in the sensitization rates to HDM between 2002 and 2007. METHODS: Four hundred fifteen patients who visited pediatric department in Dong-A medical center with bronchial asthma, allergic rhinitis and atopic dermatitis during 2002 (n 5 201) and 2007 (n 5 215) were enrolled. We reviewed medical records retrospectively to determine serum total eosinophil count (TEC), total IgE and specific IgE to HDM (Dp, Df). RESULTS: The sensitization rate to Dp and Df were slightly decreased in 2007 than in 2002. (P > 0.05) According to age, sensitization rate to Dp in patients who were from 2 to 3 years old was significantly decreased in 2007 than in 2002. (P 5 0.04) According to diagnosis, sensitization rate to Dp in patients who has asthma alone was significantly decreased in 2007 than in 2002. (P 5 0.03) The sensitization rate to Df in patients who has asthma alone and asthma with allergic rhinitis were significantly decreased in 2007 than in 2002. (P 5 0.03) CONCLUSIONS: The sensitization rate to the house dust mite in Busan was decreased in 2007 than in 2002, especially at 2-3 ages, asthma with allergic rhinitis. This results could be associated with prevalence of allergic disease in Busan and I suggest multicenter studies in local area to assess the sensitization rate to other allergens.
910
Sensitization to Domestic Mites in Santo Domingo (The Caribbean) A. J. Castillo1, E. Fernandez-Caldas2, H. Barata3; 1Allergy and Asthma Center, Santo Domingo, Dominican Republic, 2Allergy Innovations GmbH; R&D Department, Starnberg, Germany, 3Laboratorios Diater, R&D Department, Buenos Aires, Argentina. RATIONALE: Mite allergy is common in the Caribbean and, in general, in the tropics. The objective of this study was to establish the rate of sensitization to 9 mite species in consecutive allergic patients evaluated at an outpatient clinic in Santo Domingo, where to the best of our knowledge, no studies are available on mite sensitivity. METHOD: Sixty consecutive patients (51.6 females) (mean age 30.5 years; 3-67) with asthma and/or allergic rhinoconjunctivitis were skin tested with commercial extracts of the following mite species: Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis, B. kulagini, Acarus siro, Lepidoglyphus destructor, Tyropahgus putrescentiae, Glycyphagus domesticus and Chortoglyphus arcuatus. Other allergens included: dog, cat, molds, grasses, trees and weeds. A skin test was considered positive when the wheal was > 3 mm with erythema. Conventional exclusion criteria were used. RESULTS: A positive skin test to any of the allergens tested was detected in 98.3% of the patients; 98.3% reacted to at least 1 mite species; 10% were exclusively positive to Dermatophagoides spp.; 8% were exclusively positive to non-Dermatophagoides spp.; 80% reacted to Blomia spp. and 5% were exclusively positive to B. tropicalis; 78% were sensitized to 3 or more mite species. CONCLUSIONS: There is a high prevalence of skin test sensitivity to mite species in allergic patients in Santo Domingo. Sensitization to several species is common. B. tropicalis is an important species in this region. Future studies will compare these results with the mite fauna in houses in Dominican Republic and evaluate cross reactivity of all these mite species.
TUESDAY
907