A Severe Response to Substances Released From Cotton

Stanley S. Lefkowitz, PhD; Doris L. Lefkowitz, MS
JAMA. 1984;251(14):1835-1836. doi:10.1001/jama.1984.03340380021015.
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To the Editor.—  Cotton dust has been implicated in the etiology of byssinosis as well as other important respiratory diseases.1 It also has been reported that inhalation of cotton dust can result in antibody-independent complement activation causing histamine release resulting in airway changes.2,3

Report of a Case.—  A 39-year-old woman with a history of asthma was having continual respiratory problems. Initially she had laryngeal edema coupled with headaches and frequent lethargy. These symptoms seemed to be somewhat cyclic, with remissions in the evenings and on Sundays. Because of the time of the year, it was suggested that her symptoms could relate to cotton ginning, which is of considerable importance in this area. It was subsequently noted that when she left the cotton ginning and growing area, her symptoms would disappear. These severe manifestations, however, would recur after she returned to the area.A number of radioallergosorbent tests as


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