Asthma due to inhaled chemical agents—complex salts of platinum

Abstract

Sixteen workers, from a platinum refinery, with respiratory disease were tested with solutions of complex salts of platinum and ten gave immediate prick test reactions to concentrations of 10"*-10"* and immediate nasal reactions in seven out of eleven tested to concentrations of IO~^-1O'\ Occupational-type exposure inhalation tests to the dust from mixtures of 40 mg of the platinum salt with 1 kg of lactose gave immediate asthmatic reactions in eight and in one of these a late reaction, all also giving immediate prick test reactions. The asthmatic reactions were inhibited by disodium cromoglycate. In two with negative prick tests, late asthmatic reactions were elicited. The occupational-type exposure test provides a safe, acceptable procedure for etiological diagnosis.

Allergy to the complex salts of platinum. A review of the literature and three case reports.

“…Lung physiological studies of sensitized workers have demonstrated immediate, late, and dual asthmatic reactions, all of which can be inhibited by the inhalation of cromolyn sodium (Lomudal®) before the inhalation provocation test (15). This effect of cromolyn sodium suggests that both the immediate and late reactions are provoked by IgE-mediated mast cell degranulation.…”

“…The immunological reaction reviewed can be used for diagnostic purposes (15). It is easy to perform a skin test with platinum chloride or an even more sensitive test with hexachloroplatinate, with either an epicutaneous or a prick test technique (2,18).…”

“…To confirm the diagnosis of hypersensitivity to complex salts of platinum, a skin test is performed, usually as a prick test (2,5,15,18), but even epicutaneous application may be used <18). Inhalation of the dust of ammonium hexachloroplatinate can be used for a definite confirmation of the diagnosis.…”

Jack Pepys' contributions to the medical literature

“…17 Most often, the suspected agent was mixed in increasing amounts with lactose, which the patient poured back and forth from one tray to another (Figs 1 and 2). This approach was used for piperazine hydrochloride 18 ; wood dusts 19 ; complex salts of platinum 20 ; products of antibiotic manufacturing such as ampicillin, benzyl penicillin, 6-amino penicillin acid and related substances, 21 spiramycin, 22 tetracycline, 23 and intermediate products of sulbutamol 24 ; wheat flour for baker's asthma 25 ; and insect products such as carmine 26 and locusts from a breeding facility. 27 When the occupational exposure resulted from fumes, these were generated for the challenges, as with aminoethyl ethanolamine in aluminum soldering, 28 colophony (pine resin) soldering flux, 29 and electronic soldering 30 ; epoxy resins containing phthalic acid anhydride, trimellitic acid anhydride, and triethylene tetramine 31 ; toluene diisocyanate as a component of varnishes 32 ; and fumes from persulfate salts and henna used in hairdressing.…”

Occupational asthma

“…High-molecular-weight agents are mainly proteins that may act as complete antigens and stimulate IgE synthesis. Some low-molecularweight chemicals (<5 kDa), such as acid anhydrides (14), platinum salts (15), and persulfate salts (16), may act as haptens and stimulate IgE production by combining with a protein to form a haptenprotein conjugate.…”