OCCUPATIONAL EOSINOPHILIC CONSTRICTIVE BRONCHIOLITIS WITH ASTHMA IN A FOAM CUTTER CAUSED BY SOYA BEAN PRODUCTS

1 J Hoyle, 1K Ballance, 2H Francis, 2CAC Pickering, 2RMc Niven.

Author address: 

1North Manchester General Hospital, Manchester, UK; 2North West Lung Centre, Wythenshawe Hospital, Manchester, UK

Abstract: 

Introduction and background Soya bean dust is a recognised cause of asthma. More recently Soya bean has bean used in the manufacture of foam. The main market for this ’environmentally friendly foam’ is for cot mattresses. We describe a case of occu- pational asthma with eosinophilic constrictive bronchioloitis caused by cutting foam manufactured using Soya bean. This is the first case in world literature to the authors9 knowledge where Soya bean induced respiratory allergy has been described in this way. Case description 26-year male smoker presents with a 3-month history of fatigue, 10 kg weight loss, cough and work related breathlessness. Soya-based foam had been introduced into the work place 6 months prior to presentation, which the subject cut with a band knife. No respiratory protection or ventilation was used. No previous allergies or asthma were known. Throat itch preceded symptom onset. Other workers complained of conjunc- tivitis. At presentation the subject was apyrexial, oxygen sats 88% air, CRP 0.7, peripheral eosinophils 1.6 (14%), WBC normal and FEV1 34% predicted. Vasculitis and HIV screening negative. HRCT confirmed constrictive bronchiolitis, which resolved after a course of oral steroids. Lung function returned to normal. The subject was re-introduced to work where a marked drop in FEV1 was documented (Abstract P7 Figure 1). Bronchoscopy showed mucus plugging with eosinophilic casts. Peripheral eosinophilia increased with general fatigue. Total IgE remained normal, IgE for Aspergillus fumigatus
2010

abstract No: 

P7

Full conference title: 

British Thorasic Society Winter Meeting 2010
    • BTSWM 2010