About the patient
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Case presentation
Elna is a 36-year-old baker who has a 1-year history of asthma and allergic rhinitis symptoms, including episodic cough, wheeze, shortness of breath, and chest tightness with itchy red watery eyes and stuffy, runny, itchy nose. These symptoms become worse within 1-2 hours of starting work each day and worsen throughout the work week. She especially finds red bran to worsen her symptoms almost immediately after exposure. She notices an improvement within 1-2 hours outside of being at her workplace. Her past medical history is significant for seasonal allergic rhinitis in the summer months since childhood. Her family history is significant for asthma in her mother and brother.
Diagnosis and Management
A diagnosis of occupational asthma from wheat (including wheat germ and bran) was made. She was then transferred to the packaging department where flour exposure was minimal, if any, and was followed with further peak flow monitoring and spirometry. She has since remained well with no symptoms and requires no medications.