A case of occupational bronchial asthma due to morphine in a nonatopic 46-year-old woman is presented.
The following diagnostic tests were used : a workplace trial with bronchodilator and placebo, and single-blind, placebo-controlled nasal and bronchial challenge with 0.5% morphine HCl.
For the nasal challenge, four asthmatic patients were selected as a control group.
The nasal washings were done before and 30 min, 3 h, 24 h, and 48 h after all challenges.
In the nasal lavage fluid, the total numbers of eosinophils, neutrophils, basophils, and mast cells were counted, and, after the nasal challenge, total protein and albumin levels were measured.
During the workplace trial, the PEF variability ratio increased from 5% to 38%. After the challenges, a decrease in the spirometric parameters (VC and FEV1) of about 30-40% was observed, with minimums at 24 and 48 h. An influx of granulocytes with an increase in the relative number of eosinophils and basophils from 3 h until 48 h after the challenge was observed in the nasal lavage fluid.
The protein level in the nasal lavage fluid increased from 190 to 1275 mug/ml 24 h after the challenge with an increase of relative albumin level from 24% to 40% at 24 h. In the control group, no changes in relative number of basophils and eosinophils and albumin/total protein ratio in the nasal lavage fluid or in the spirometric parameters were observed after the challenge.
Mots-clés Pascal : Asthme, Rhinite, Allergie, Morphine, Médicament, Test provocation, Nez, Hypersensibilité retardée, Exposition professionnelle, Diagnostic, Etude cas, Pologne, Europe, Adulte, Homme, Appareil respiratoire pathologie, Bronchopneumopathie obstructive, ORL pathologie, Nez pathologie, Immunopathologie, Opiacés, Médecine travail, Maladie professionnelle
Mots-clés Pascal anglais : Asthma, Rhinitis, Allergy, Morphine, Drug, Provocation test, Nose, Delayed hypersensitivity, Occupational exposure, Diagnosis, Case study, Poland, Europe, Adult, Human, Respiratory disease, Obstructive pulmonary disease, ENT disease, Nose disease, Immunopathology, Opiates, Occupational medicine, Occupational disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0134510
Code Inist : 002B02U10. Création : 21/05/1997.