OCCUPATIONAL ASTHMA AND CONTACT URTICARIA FROM DRIED FLOWERS OF LIMONIUM-TATARICUM

Dried flowers of Limonium tataricum (LT) are widely used for semipermanent floral arrangements. We report a case of a floral industry worker in whom exposure to LT precipitated rhinoconjunctivitis, asthma, and contact urticaria. Studies revealed the presence of immediate skin test reactivity and positive leukocyte histamine release in response to LT extract. Specific anti-LT antibodies were detected in the patient's serum by direct RAST. Bronchial challenge with LT extract also resulted in an isolated immediate asthmatic response. Both the positive methacholine inhalation test and the significant changes observed in PEFR measurements when the patient handled LT supported the diagnosis of occupational asthma. These findings strongly suggest that an IgE-mediated immunologic mechanism is responsible for the patient's respiratory and cutaneous symptoms.