Eosinophilic airway disease in a patient with a negative skin prick test, but a positive patch test with platinum salts--implications for medical surveillance.

Abstract

We present the case of a 52-year-old woman with a topic dermatitis since adolescence who developed work-related hand eczema, cough and runny nose 12 years after she had started working as a laboratory technician at a precious metals refinery. While skin prick test with sodium hexachloroplatinate (SPTPt ) was negative, patch testing with ammonium tetrachloroplatinate was positive after 24, 48, 72, and 96 hr. Inhalation challenge with sodium hexachloroplatinate yielded cough, mild shortness of breath, and a maximal decrease of FEV1 of 8% from baseline 24 hr after the challenge. Significant increases of bronchial hyperresponsiveness, exhaled nitric monoxide and sputum eosinophils were documented after the challenge. We conclude that eosinophilic airway disease due to platinum salts may occur in SPTPt negative subjects. Both, patch testing and inhalation challenge with platinum salts should be considered in SPT negative subjects with occupational exposure to precious metal salts and work-related allergic symptoms.

• Authors: Rolf Merget, Manigé Fartasch, Ingrid Sander, Vera Van Kampen, Monika Raulf, Thomas Brüning
• Journal: American journal of industrial medicine (Am J Ind Med) Vol. 58 Issue 9 Pg. 1008-11 (Sep 2015) ISSN: 1097-0274 [Electronic] United States
• PMID: 26010732 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2015 Wiley Periodicals, Inc.

Chemical References

• Salts
• Platinum

Topics

• Eczema (diagnosis, etiology)
• Female
• Hand
• Humans
• Metallurgy
• Middle Aged
• Occupational Diseases (diagnosis, etiology)
• Occupational Exposure (adverse effects)
• Patch Tests
• Platinum (toxicity)
• Pulmonary Eosinophilia (diagnosis, etiology)
• Salts (toxicity)
• Skin Tests