DIAGNOSTIC PROCEEDING IN OCCUPATIONAL INHALATIVE ALLERGY TYPE-IV

Nowadays, the increasing industrial production of chemical substances in the western hemisphere enlarges dramatically the risk of allergic a nd toxic damages in the upper respiratory tracts. Occupational inhalat ion of irritative agents plays an important role as an exposition mode , and at this, possible delayed hypersensitivity type IV reactions hav e to be considered. However, there exist many difficulties to differen tiate an allergy type IV from chronic irritative or toxic reactions in the respiratory mucosa. Further efforts are necessary to find more re liable diagnostic methods. As an example, the well-documented case of an allergic rhinopharyngolaryngitis due to inhalation of low-molecular solvents is reported. By this way, the diagnostic proceeding in ENT t o ensure an occupational allergy type IV can be demonstrated. Besides patch testing, endoscopically, rhinomanometrically, and bodyplethysmog raphically controlled provocation tests and the estimation of lymphocy te subpopulations before and after challenge were performed. The chara cteristic results confirmed the delayed cell-mediated allergic reactio n, caused by 2-butanon and phenol exposition.