[Anterior rhinomanometry as a diagnostic test in occupational allergy caused by Liliaceae]

The Liliacea family has been implicated as a cause of occupational rhinoconjunctivitis and bronchial asthma. We report a patient who presented symptoms when he manipulated spices including garlic and onion dusts. Nasal challenge test with active anterior rhinomanometry was used for the diagnosis.

Skin-prick tests with common inhalants, commercial spices, fresh Liliaceae and powdered spices diluted in saline solution (10 mg/ml) were performed. Immunoblot and specific IgE (CAP-Pharmacia) were determined. Control peak expiratory flow was monitored during a period at work in an area where spices were manipulated and in an area where they were transported. Nasal challenge test with garlic and onion powder was performed. The resulting nasal obstruction was measured as nasal airway resistance and was determined by rhinomanometry.

Skin-prick tests were positive for onion, garlic powder and fresh Liliacea. Specific IgE were positive for garlic and onion. IgE immunoblotting showed very strong bands at 14 and 40 kD with garlic extract. Nasal challenge showed an increase in inspiratory nasal resistance which was higher than 100 % of the basal value for both onion extract and garlic.