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Canadian Respiratory Journal
Volume 19 (2012), Issue 6, Pages 385-387
http://dx.doi.org/10.1155/2012/723049
Clinico-Pathologic Conferences

Integrated Approach to Diagnosis of Associated Occupational Asthma and Rhinitis

Sébastien Nguyen,1,2 Roberto Castano,1,2 and Manon Labrecque1,2

1Respiratory Research Division, Research Center, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Quebec, Canada
2Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with coexisting work-related rhinitis and asthma would benefit from an adequate and simultaneous recognition of both diseases. The present case illustrates the advantages and importance of using an integrated approach to confirm a diagnosis of occupational rhinitis (OR) and occupational asthma (OA).

A 38-year-old woman, who worked as an animal laboratory technician since 2004, first noticed the appearance of rhinitis and conjunctivitis symptoms in 2007 when she was exposed to rats. A skin-prick test with rat extract was strongly positive. A specific inhalation challenge with parallel assessment of nasal and bronchial responses was conducted. After 10 min of exposure, she developed rhinitis and conjunctivitis symptoms, her forced expiratory volume in 1 s dropped by 27.5% and her nasal volume, measured by acoustic rhinometry, decreased by 80% from baseline values. After allergen exposure, induced sputum and nasal lavage examination demonstrated an increase in eosinophils (11% and 20%, respectively). A diagnosis of associated allergic OA and OR was confirmed and she was advised to stop working with rats.

A systematic and parallel diagnostic approach enables confirmation of a diagnosis of OA and OR in patients complaining of work-related rhinitis and asthma symptoms.