Immediate and delayed allergy to nickel with contact urticaria, rhinitis, asthma and contact dermatitis

Abstract

A 27-year-old woman had for 2 years performed manual grinding of metal castings that contained nickel. She had previously had allergic contact dermatitis from nickel but started to get contact urticaria, rhinitis and asthmatic attacks at work. The symptoms disappeared at weekends and on holiday. Scratch chamber tests, open tests, specific IgE determinations (RAST), and RAST-inhibition test indicated that she had developed an IgE-mediated allergy to nickel; the bronchial provocation reaction with NiSO4 was, however, a late one. Patch tests confirmed her allergic contact dermatitis to be caused by nickel. This is the first patient, to the best of our knowledge, reported to have developed allergic contact dermatitis, allergic contact urticaria, rhinitis and asthma from nickel.

Patients with urticaria are at a higher risk of anaphylaxis: A nationwide population‐based retrospective cohort study in Taiwan

“…Mast cells combined with IgE can release cytokines, such as histamine, prostaglandins and leukotriene, to arouse inflammation. On the other hand, IL‐5 can attract eosinophils and cause contraction of smooth muscle of the airway and inflammation as well . We found some reference data for several diseases associated with urticaria.…”

Occupational Allergic Contact Dermatitis and Asthma due to a Single Low Molecular Weight Agent

“…In observations of ACD and OA caused by a single metal, Eslander et al 12) , and more recently, Spinelli et al 14) reported cases with allergic contact dermatitis, allergic contact urticaria, rhinitis and asthma from nickel. De Raeve et al, in 1998, reported that a subject, with allergic contact dermatitis to chromates, may develop a respiratory allergic reaction to an airborne source of this metal 13) .…”

“…De Raeve et al, in 1998, reported that a subject, with allergic contact dermatitis to chromates, may develop a respiratory allergic reaction to an airborne source of this metal 13) . However, the relationship between the pathophysiological mechanisms of ACD and asthma caused by a single metal is not well-known [12][13][14] . In our 3 case reports, the observation of delayed bronchial responses with positive patch tests to LMW agents such as DGEBA or HEMA suggest that expiratory troubles could be linked to a cell-mediated mechanism 16) .…”

“…This IgE-mediated allergy has also been identified for some LMW agents responsible for OA, such as anhydric acids 4) , reactive dyes 5,6) , platinum salts 7,8) , and other metals [9][10][11] . Metals have been reported to cause both allergic contact dermatitis (ACD) and OA in the same factory [12][13][14] . However, the relationship between the pathophysiological mechanisms of these two manifestations from a single causative agent is not well-known.…”

Rhinitis caused by ninhydrin develops into occupational asthma

“…Ninhydrin can cause skin irritation, and has already been shown to cause type IV allergic eczema [2,3]. An increasing number of other "contact allergens" have now been shown to induce type I allergic reactions, verified with specific IgE measurements or specific challenge tests, such as nickel [13,14], acrylates [15] and epoxy resin [16].…”