Tetrachlorophthalic anhydride asthma: evidence for specific IgE antibody.

We describe seven women with asthma induced by occupational exposure to an acid anhydride, tetrachlorophthalic anhydride (TCPA), an epoxy resin hardening agent. Inhalation tests with TCPA at atmospheric concentrations of less than one tenth of a manufacturer's recommended exposure limit provoked asthmatic reactions in the four women tested. None had evidence of pretest bronchial hyperreactivity. Immediate skin prick test reactions were elicited in the seven subjects by a conjugate of TCPA with human serum albumin (TCPA-HSA) but not in others tested. Specific IgE antibody levels to TCPA-HSA, measured by radioallergosorbent test scores, were significantly elevated in the seven, but not in TCPA-exposed and unexposed comparison groups. These results imply that occupational asthma caused by TCPA is an allergic reaction mediated by specific IgE antibody.