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BMC Pulm Med. 2015 Mar 6;15:18. doi: 10.1186/s12890-015-0013-3.

Working with argan cake: a new etiology for hypersensitivity pneumonitis.

Paris C1,2, Herin F3,4, Reboux G5,6, Penven E7,8, Barrera C9,10, Guidat C11, Thaon I12,13.

Author information

1
Université de Lorraine, INGRES, EA 7298, Vandoeuvre lès Nancy, F-54505, France. christophe.paris@inserm.fr.
2
CHU Nancy, Centre de consultations de pathologies professionnelles, Vandoeuvre lès Nancy, F-54511, France. christophe.paris@inserm.fr.
3
CHU Toulouse, Service des Maladies Professionnelles et Environnementales, Toulouse, F-31000, France. herin.f@chu-toulouse.fr.
4
Université de Toulouse, UMR 1027, Toulouse, F-31000, France. herin.f@chu-toulouse.fr.
5
UMR/CNRS 6249 Chrono Environnement, Université de Franche-Comté, Besançon, F-25030, France. gabriel.reboux@univ-fcomte.fr.
6
Service de Parasitologie-Mycologie, CHU J. Minjoz, Besançon, F-25030, France. gabriel.reboux@univ-fcomte.fr.
7
Université de Lorraine, INGRES, EA 7298, Vandoeuvre lès Nancy, F-54505, France. e.penven@chu-nancy.fr.
8
CHU Nancy, Centre de consultations de pathologies professionnelles, Vandoeuvre lès Nancy, F-54511, France. e.penven@chu-nancy.fr.
9
UMR/CNRS 6249 Chrono Environnement, Université de Franche-Comté, Besançon, F-25030, France. coralie.barrera@univ-fcomte.fr.
10
Service de Parasitologie-Mycologie, CHU J. Minjoz, Besançon, F-25030, France. coralie.barrera@univ-fcomte.fr.
11
Association Lorraine de Santé en Milieu de Travail, Pulnoy, F-54425, France. cguidat@alsmt.org.
12
Université de Lorraine, INGRES, EA 7298, Vandoeuvre lès Nancy, F-54505, France. isabelle.thaon@univ-lorraine.fr.
13
CHU Nancy, Centre de consultations de pathologies professionnelles, Vandoeuvre lès Nancy, F-54511, France. isabelle.thaon@univ-lorraine.fr.

Abstract

BACKGROUND:

Argan is now used worldwide in numerous cosmetic products. Nine workers from a cosmetic factory were examined in our occupational medicine department, following the diagnosis of a case of hypersensitivity pneumonitis (HP) related to handling of argan cakes.

METHODS:

Operators were exposed to three forms of argan (crude granulates, powder or liquid) depending on the step of the process. All workers systematically completed standardized questionnaires on occupational and medical history, followed by medical investigations, comprising, in particular, physical examination and chest X-rays, total IgE and a systematic screening for specific serum antibodies directed against the usual microbial agents of domestic and farmer's HP and antigens derived from microbiological culture and extracts of various argan products. Subjects with episodes of flu-like syndrome several hours after handling argan cakes, were submitted to a one-hour challenge to argan cakes followed by physical examination, determination of Carbon Monoxide Diffusing Capacity (DLCO) and chest CT-scan on day 2, and, when necessary, bronchoalveolar lavage on day 4.

RESULTS:

Six of the nine workers experienced flu-like symptoms within 8 hours after argan handling. After challenge, two subjects presented a significant decrease of DLCO and alveolitis with mild lymphocytosis, and one presented ground glass opacities. These two patients and another patient presented significant arcs to both granulates and non-sterile powder. No reactivity was observed to sterile argan finished product, antigens derived from argan cultures (various species of Bacillus) and Streptomyces marokkonensis (reported in the literature to contaminate argan roots).

CONCLUSIONS:

We report the first evidence of hypersensitivity pneumonitis related to argan powder in two patients. This implies preventive measures to reduce their exposure and clinical survey to diagnose early symptoms. As exposure routes are different and antibodies were observed against argan powder and not the sterile form, consumers using argan-based cosmetics should not be concerned.

PMID:
25888313
PMCID:
PMC4369362
DOI:
10.1186/s12890-015-0013-3
[Indexed for MEDLINE]
Free PMC Article

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