Extrinsic allergic alveolitis due to inhaled molds in occupational onion and potato processing: onion- and potato-sorter alveolitis

Abstract

Background:

Only one case of occupational extrinsic allergic alveolitis due to mold inhaled during the sorting and transportation of onions and potatoes has been described in the literature to date. While having been exposed for one year the disease had healed up completely. Penicillium and Fusarium molds could be identified as cause of the extrinsic allergic alveolitis. We observed the second such patient albeit with more pronounced symptoms. We describe the patient’s severe symptoms as well as his broader range of antibodies.

Methods:

Assessment of comprehensive documentation as part of the medical examination, interview of former attending physicians, and additional IgG antibody investigations by ELISA and CAP-FEIA technique in order to detect more than the thus far known antigens.

Results:

A 53-year-old male non-smoker of German descent, who had worked in the sorting and transportation business of onions and potatoes for more than 20 years was diagnosed with an occupational extrinsic allergic alveolitis. Possible triggers are the molds Penicillium chrysogenum, Aspergillus fumigatus, Fusarium proliferatum, and Cladosporium herbarum—against all of which IgG antibodies were detected in the patient’s serum. After antigen avoidance symptoms improved. Interstitial lesions visible on X-ray, a significant diffusion impairment, and a pulmonary hypertension have persisted, though. The disease was accepted as a occupational disease.

Conclusions:

Sorting onions and potatos not only can elicit moderate symptoms of an allergic alveolitis that heal without consequences, but can also lead to irreversible lung fibrosis associated with pulmonary hypertension. According to our findings, in addition to Penicillium, Fusarium, and Aspergillus molds Cladosporium herbarum is a possible antigen, too. Thus, this type of extrinsic allergic alveolitis is a serious notifiable occupational disease.

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Correspondence to Prof. Dr. Joachim Sennekamp.

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The authors state that there are no conflicts of interest.

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Sennekamp J, Juergens L-J, Sturm M, Juergens UR. Extrinsic allergic alveolitis due to inhaled molds in occupational onion and potato processing: onion- and potato-sorter alveolitis. Allergo J Int 2016;25:138–43 DOI: 10.1007/s40629-016-0120-6

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Sennekamp, J., Juergens, L., Sturm, M. et al. Extrinsic allergic alveolitis due to inhaled molds in occupational onion and potato processing: onion- and potato-sorter alveolitis. Allergo J Int 25, 138–143 (2016). https://doi.org/10.1007/s40629-016-0125-1

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Key words

  • extrinsic allergic alveolitis
  • hypersensitivity pneumonitis
  • mold allergy
  • occupational disease
  • interstitial lung disease
  • pulmonary fibrosis
  • IgG antibodies