Double sensitization to enzymes in a baker

Occupational Asthma Related to Mouse Allergen Exposure and Rhinoconjunctivitis due to Collagenase Inhalation in a Laboratory Technician

“…The possibility of presenting double or multiple sensitivity against unrelated antigens is rarely cited. Santaolalla et al [20] described a case of double sensitization to fungal α-amylase and egg lysozyme in a baker, and Lee et al [21] reported a case of OA and rhinitis caused by multiple herbal agents in a pharmacist. The double sensitization in our patient was probably not due to an atopic state, because the levels of total IgE were low and skin prick tests to common pneumoallergens were negative.…”

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“…Case reports: since the link between amylases and allergy is well-documented thru numerous epidemiological studies, case studies worth mentioning fall a bit outside of the classical baker's asthma. Interesting case reports on amylase include a double sensitization to lysozyme and amylase in a baker with rhinoconjunctivitis and asthma [135], a sensitization occuring from infrequent contact with the enzyme in a lab technician showing symptoms localized on her hands without nasal or respiratory effects [136], and one case of occupational allergic contact urticaria from fungal but not bacterial alpha-amylase [137]. Two cases of IgEmediated rhinitis have also been reported in hospital and pharmaceutical workers exposed to biodiastase, a prescription drug based on alpha-amylase [138].…”