[Asthma and rhinoconjunctivitis caused by rape flour: description of a clinical case]

A 48 year old man, employed in a grain and animal feed store for 9 years, was referred to our clinic complaining of nasal blockage, rhinorrhea, sneezing, ocular burning, coughing and wheezing occurring over the last 12 months. The man's main task was to manually load and unload the unpackaged grain and feed. Symptoms occurred only when he worked directly with oilseed rape flour and not when he worked with other types of grains. Eye and nasal symptoms appeared during the work shift, while respiratory symptoms were worse at night than during the day after exposure to rape for more than 2 consecutive days. Physical examination was normal, as were the results of the pulmonary function studies. The methacholine inhalation test, performed to measure the level of non-specific airways responsiveness, showed normal bronchial reactivity. Results of allergy skin prick tests were negative for common inhalant and food allergens, but slightly positive for the oilseed rape flour extract. Registration of the peak expiratory flow (PEF) showed slight decreases in PEF values after occupational exposure. We conclude that this case is suggestive of asthma and rhino-conjunctivitis, induced by oilseed rape flour, probably due to an allergic mechanism.