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Eucalyptus as a specific irritant causing vocal cord dysfunction.

John T Huggins1, Allen Kaplan, Bonnie Martin-Harris

  • 1Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. hugginjtmusc.edu

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|October 14, 2004
PubMed
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Eucalyptus exposure can trigger vocal cord dysfunction (VCD), a condition mimicking asthma. This study suggests respiratory irritants may cause VCD through a non-allergic pathway.

Area of Science:

  • Pulmonology
  • Otolaryngology
  • Allergy and Immunology

Background:

  • Vocal cord dysfunction (VCD) is a condition where vocal cords close inappropriately during inhalation, often mistaken for asthma.
  • The exact cause of VCD remains unclear, with prior research suggesting respiratory irritants as a potential trigger.

Observation:

  • This case study details a 46-year-old woman experiencing VCD triggered by eucalyptus exposure.
  • Flexible fiberoptic nasolaryngoscopy was used to confirm VCD onset specifically with eucalyptus, differentiating it from other irritants like ammonia and pine oil.

Findings:

  • VCD symptoms manifested within minutes of eucalyptus inhalation, prospectively documenting eucalyptus as a specific VCD precipitant.
  • Non-allergic mechanisms are suggested by negative skin prick tests, normal total IgE, and absent eucalyptus-specific IgE antibodies.

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Implications:

  • This research proposes a novel pathogenic pathway for VCD, highlighting respiratory irritants as a potential non-immunologic trigger.
  • Further investigation into irritant-specific VCD mechanisms is warranted to understand and manage this condition effectively.