SOYBEAN ASTHMA OUTBREAK - A CLINICAL AND IMMUNOLOGICAL STUDY

BACKGROUND: TO study the clinical and immunological data of patients a ffected by a soybean asthma outbreak in Tarragona, Spain. PATIENTS AND METHODS: Characteristics of previous asthma, emergency rooms records and immediate outcome of 15 patients who attended emergency room depar tments the epidemic day were recorded. Functional respiratory studies, skin prick tests to aeroallergens, and prick tests, specific IgE and immunoblotting to soybean extracts were performed in all patients. RES ULTS: Thirteen patients were sensitized to soybean proteins. All of th em were atopic (most sensitized to house dust mites) and half had star ted asthma symptoms after their thirties. The epidemic crisis was part icularly severe in patients over 50 years, daily chronic asthma, sever e obstructive pattern and/or non receiving steroids. Four patients wer e admitted to intensive care units. Seven patients showed asthma exace rbations (late reactions) 24 h after the beginning of the epidemic cri sis, Specific IgE against a 5-6 kD and a 15.5-17 kD soybean proteins w as detected in the sera of 8 patients and 10 patients, respectively, C ONCLUSIONS: The outbreak affected atopic patients exposed to soybean d ust. The severity of the crisis was related with the previous severity of asthma. Besides the well known 5-6 kD allergenic soybean protein, the 15.5-17 kD protein seems also to be implicated in the sensitizatio n of most of these patients.