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Occupational Medicine Advance Access published online on July 21, 2006
Occupational Medicine, doi:10.1093/occmed/kql025
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Case Report

Anaphylaxis and allergic contact urticaria from occupational airborne exposure to HBTU

Timo Hannu 1 *, Kristiina Alanko 1, and Helena Keskinen 1

1 Department of Occupational Medicine, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FI-02500 Helsinki, Finland

* To whom correspondence should be addressed.
Timo Hannu, E-mail: timo.hannu{at}ttl.fi


  Abstract

We describe a case of anaphylaxis and allergic contact urticaria from occupational airborne exposure to HBTU (o-(benzotriazol-1-yl)-N,N,N',N'-tetramethyluronium hexafluorophosphate), which is a chemical used widely for solid and solution-phase peptide synthesis. Previously, the use of this chemical has been associated with occupational asthma, allergic contact urticaria and allergic contact dermatitis in individual cases, but not with anaphylaxis. Our diagnoses were based on the clinical symptoms, positive skin prick test (SPT) and positive skin provocation test to HBTU. The positive SPT indicates that the anaphylaxis reaction was IgE-mediated. We recommend that in the handling of HBTU, appropriate safety measures should be compulsory, and if work-related symptoms develop, the possibility of anaphylaxis should be considered in advising on appropriate work tasks.

Keywords: Allergic contact urticaria; anaphylaxis; CAS 94790-37-1; HBTU; peptide synthesis.
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