Occupational rhinitis and bronchial asthma due to TBTU and HBTU sensitization.

J C Miralles, J M Negro, J M Alonso, M García, F Sánchez-Gascón, J Soriano

Allergy Section, University General Hospital, Murcia, Spain. jmiralles1@meditex.es

Journal of investigational allergology & clinical immunology 2003

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Exposure to an increasing amount of products in the work environment is leading to new cases of occupational asthma among workers. We report the case of a worker at a pharmaceutical plant who developed occupational rhinitis and bronchial asthma due to HBTU: 2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate and TBTU: 2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate sensitization, two chemical products widely used in peptide synthesis and coupling. Skin tests (prick test) with HBTU and TBTU solutions in PBS were positive at a concentration of 1 mg/ml. Skin tests with the same solutions in 10 atopic controls yielded a negative result. Nasal challenge tests with these products were positive with HBTU at a concentration of 0.01 mg/ml and TBTU at a concentration of 1 mg/ml. In both cases PNIF (peak nasal inspiratory flow) decreased by more than 60% and severe sneezing and rhinorrhea were induced. Nasal challenge tests performed on 10 atopic controls with TBTU and HBTU at a concentration of 1 mg/ml were negative. We conclude that the patient presents occupational rhinitis and bronchial asthma due to TBTU and HBTU; the operational mechanism is probably immunological IgE-mediated given the positive prick tests and nasal challenge with these products.

Citation

J C Miralles, J M Negro, J M Alonso, M García, F Sánchez-Gascón, J Soriano. Occupational rhinitis and bronchial asthma due to TBTU and HBTU sensitization. Journal of investigational allergology & clinical immunology. 2003;13(2):133-4