Allergic immediate-type reactions by halogenated compounds of
platinum (Pt) (
platinum salts) have been described in workers in precious
metal refineries and catalyst productions. In both industries there are exposures to many different Pt compounds. It is believed that the most important
allergens are those compounds with the highest number of halide
ligands. It is unknown whether sensitizations to compounds with a lower number of halide
ligands represent co-sensitizations or are due to cross-reactivity. We report a worker engaged in the production of cytotoxic drugs with
occupational asthma and exposure to only one Pt
salt with four halide
ligands. The 22-year-old worker developed work-related
sneezing,
runny nose, and variable
dyspnea about a year after he had started to work in the cytotoxic drugs production with exposure to
potassium tetrachloroplatinate(II) (K(2)PtCl(4)). He was immediately removed from his workplace and admitted for a medical opinion about 6 months afterwards. Spirometry was normal, but
asthma was corroborated by a positive response to
methacholine. The results of skin prick testing could not be interpreted due to
urticaria factitia. Challenge with K(2)PtCl(4) by a
dosimeter method yielded a clear immediate-type reaction with an increase of exhaled
nitric oxide from 32 to 156 ppb after 24 h indicating an increased airway
inflammation. Pt
salts with four halide
ligands like K(2)PtCl(4) may cause an allergic immediate-type reaction and
occupational asthma. Workers in the production of Pt-containing cytotoxic drugs with exposure to these substances should be included in medical surveillance programs for the prevention of
occupational asthma caused by Pt
salts.