Patient 1 Asthma induced by buckwheat | Patient 2 Asthma induced by wheat | ||
Age, sex | 54, man | 42, man | |
Occupation | Factory making buckwheat noodles | Baker | |
History of the work | 36 y, since age 18 | 16 y, since age 26 | |
Habits | Non-smoker and social drinker | Non-smoker and never drinker | |
Peripheral eosinophils (%) | 23 | 0 | |
Total IgE (IU/ml) | 176 | 458 | |
FEV1 (% predicted) | 1.31 (49%) | 3.89 (69.5%) | |
PaCO2, PaO2 (mm Hg) | 42, 60 | 40, 93 | |
PC201-150 (mg/ml) | 0.625 | 0.128 | |
Chestx ray film | Normal | Normal | |
Prick test1-151 (mm) | Buckwheat flour extract | Wheat flour extract (10−3 g/ml) | |
10−3 g/ml: 4 × 4 / 28 × 25 | A–F: all positive | ||
10−4 g/ml : negative | |||
Skin test (mm) | Buckwheat flour extract: | Wheat flour extract: (threshold) | |
10−6 g/ml: 12 × 10 / 40 × 33 | A: 10−6 g/ml, B: 10−5 g/ml, C∼F: 10−4 g/ml | ||
10−7 g/ml: negative | |||
Prausnitz-Küstner reaction | Not done | Positive for wheat flour extracts A, B, C, D, E, F | |
IgE-RAST‡ | Buckwheat flour: class 3 | Wheat flour : class 5 | |
Other 30 antigens: all negative | Other 18 antigens: all negative | ||
Bronchoprovocation test§ | Buckwheat flour extract (10−3 g/ml) | Wheat flour extract (A: 10−2 g/ml) | |
IAR: negative | IAR: 23% fall in FEV1 | ||
LAR: 32% fall in FEV1 7 h later | LAR: 33% fall in FEV1 7 h later | ||
Environmental provocation test¶ | Work for 30 minutes | Work for 15 minutes | |
IAR: negative | IAR: 39% fall in PEFR | ||
LAR: 44% fall in PEFR 9 h later | LAR: 36% in PEFR 7 h later |
↵1-150 Non-specific methacholine bronchial provocation test.
↵1-151 Results of the skin prick test were expressed as wheal / flare (mm). In Patient 2, antigens were prepared using six components (component A–F) of the wheat flour that were usually used by the patient (see text).
RAST: radioallergosorbent test; IAR=immediate asthmatic reaction; LAR=late asthmatic reaction; PEFR=peak expiratory flow rate.