Der Nachweis beruflich verursachter Allergien ist ein komplexes Unterfangen: ein Fallbeispiel

The detection of occupational allergies is a complex undertaking: A case study According to the recommendations for the diagnosis of occupational asthma, suspected cases require a confirmed asthma diagnosis, work-associated symptoms, evidence of sensitization to an occupational allergen and a close relationship between the occupation and the symptoms. In addition to a detailed medical history, several examinations and tests and a differentiated consideration of them are required in order to arrive at a final expert assessment. We report the case of a 58-year-old butcher who had been complaining of shortness of breath and coughing at his workplace in a slaughterhouse for 5 years. It was only after extensive investigations and a detailed medical history that a powdered kebab spice used in an adjacent room was suspected as the potential allergen. Diagnostic tests showed that the patient was sensitized to the spice. While the specific inhalation challenge (SIC) with kebab spice did not elicit an asthmatic reaction, a non-specific bronchial hyperreactivity in the insured person was observed. On the day after the SIC, the bronchial hyperreactivity was increased by a factor of three and there were further indications of eosinophilic or allergic reaction. In summary, the individual diagnostic components led to the assessment of this case as allergic occupational asthma. This case illustrates that an assessment of the individual diagnostic components in the diagnosis of occupational asthma is quite complex and not without pitfalls. Keywords: occupational asthma – diagnosis – sensitization – bronchial hyperreactivity