Papain-induced occupational rhinoconjunctivitis and asthma – A case report

• Main Authors: Diana Tymoszuk, Marta Wiszniewska, Jolanta Walusiak-Skorupa
• Format: Article
• Language: English
• Published: Nofer Institute of Occupational Medicine 2016-04-01
• Series: Medycyna Pracy
• Subjects: asthma; occupational allergy; enzyme; rhinitis; papain; conjunctivitis
• Online Access: http://medpr.imp.lodz.pl/Papain-induced-occupational-rhinoconjunctivitis-and-asthma-A-case-report,61070,0,2.html

This report presents a case of occupational asthma, rhinitis and conjunctivitis to papain in a 50-year-old herbs and spices packer, with documented increased eosinophilia in induced sputum and in the nasal lavage fluids after a specific inhalation challenge test (SICT) and specific nasal challenge test (SNCT) with this enzyme. Immunoglobulin E-mediated (IgE) sensitization to papain was confirmed by positive results of a skin prick test with specific solution. Specific inhalation and nasal challenge tests demonstrated a direct and significant link between the exposure to this protease and the allergic response from the respiratory system. Additionally, the SNCT induced a severe reaction of the conjunctivae and a significant increase in the count of eosinophils in tears, despite the lack of direct contact of the allergen with the conjunctiva. Med Pr 2016;67(1):109–112