A baker's occupational allergy to flour moth (Ephestia kuehniella)

Background: Allergy to insects is common. However, few reports cover occupa tional sensitization to flour moth (Ephestia [syn. Anagasta] kuehniella). W e describe a baker who suffered from IgE-mediated occupational respiratory allergy to flour moth. Methods: The skin prick test (SPT) and serum IgE tests were used to evaluat e the patient's sensitivity to flour moth. Allergen cross-reactivity with m ites was evaluated in IgE-inhibition studies. Clinical sensitivity was eval uated by nasal challenge test. Pulmonary function tests were repeatedly mon itored. Results: SPT with flour moth gave a 6-mm wheal, and an elevated level of fl our moth-specific IgE was measured in the patient's serum (1.9 PRU/ml, RAST class 2). Immunoblotting with the patient's serum revealed at least seven heavy IgE-binding bands with molecular masses of 22, 35, 43, 53, 65, 77, an d >86 kDa in the extract of flour moth. Allergen cross-reactivity with mite s was demonstrated in inhibition studies. Immediate-type allergy to flour m oth was confirmed by nasal challenge. Increased daily variability of PEF va lues was observed during workplace exposure. Conclusions: A baker's occupational respiratory allergy to flour moth was c onfirmed.