Rhinite et asthme professionnels par sensibilisation aux allergènes de porc (albumine, gammaglobulines et protéine de 26 kDa)

We report the case of a 39 years old female industrial pork butcher who developed urticaria, rhinitis and asthma in contact with pig gut and pig-gut soaking water (LR). In addition, she developed an asthma attack after ingestion of pork meat. She was atopic, allergic to cats and dogs, and lived with a cat. Skin prick tests were positive with commercial dog and cat dander extracts, pig albumin, cat and pig gamma globulin, and LR. She was found to have high serum levels of IgE specific for cat, pig and beef albumin, for beef, sheep and pork meat, and for pig gut and LR. A bronchial challenge test with LR induced an immediate bronchial response, with a 23% drop in FEV1. SDS-PAGE electrophoresis with pork meat and LR revealed albumin (mw 67 kDa) in these samples. Immunoblots and immunoblot-inhibition assays with the patient's serum revealed evidence of IgE specific for pig albumin and gamma globulin; an allergen band with mw 26 kDa, not previously reported, was also seen. Cross-reactions between pig and cat albumin and between pig and cat gamma globulin was demonstrated by RAST inhibition. This patient represents a case of cutaneous and respiratory occupational allergy caused by pig albumin and gamma globulin, in this case acting as aeroallergens. For this patient, who has what we might call the pig-cat syndrome, we recommended that she avoid occupational exposure to pork, avoid eating pork products, and also avoid exposure to cats.