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At least 19 recordsLinked to original sources
PubMedDate not supplied

Latex hypersensitivity: two case reports.

For persons hypersensitive to latex, continued exposure may result in a life-threatening situation. Since 1979 reports appeared supporting evidence of urticaria, rhinitis, asthma, and anaphylaxis in association with latex exposure. We present two cases of latex hypersensitivity, patients who reacted to latex on skin-prick and radioallergosorbent tests (RAST). A 30-year-old surgeon developed reactions to latex gloves. On skin-prick testing to latex extract in saline, he was 4+. RAST latex antigen-specific IgE was 50.75 times control. The second case is that of a 24-year-old nurse who underwent multiple corrective surgeries for congenital birth defects and experienced reactions to latex. On skin-prick testing to an extract of latex in saline, she was 2+. RAST latex antigen-specific IgE was 23.37 times control. Both patients were given epinephrine and diphenhydramine and advised to use latex-free gloves and to avoid latex products. As health care personnel contact with latex products increases because of new guidelines for the prevention of sexually transmitted diseases, more adverse reactions in this subpopulation will occur.

Adult↗
PubMed1996

Latex hypersensitivity: its prevalence among dental professionals.

Reports of hypersensitivity to latex are growing among oral health care workers, who have a high degree of exposure to latex products. The authors undertook a study to determine the prevalence of latex hypersensitivity among oral health care workers in a hospital dental practice. Among the 34 people who participated in the study, 12 percent had positive results in a skin prick test for latex. This suggests that the true prevalence rate of immediate hypersensitivity to latex in this group of oral health care workers is similar to that in other health care workers who use latex gloves frequently.

Adult↗
PubMedDate not supplied

Characterization of latex antigen and demonstration of latex-specific antibodies by enzyme-linked immunosorbent assay in patients with latex hypersensitivity.

Two latex antigens, one extracted from surgical gloves (GE) and the other from the sap of Hevea brasiliensis plant (RPE) were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and two-dimensional gel electrophoresis. These antigens were used to detect latex specific IgE and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) in the sera of patients with meningomyelocele (spina bifida) and of normal controls. Of the 36 patients studied, 26 had wheal-and-flare skin-prick test reactivity to latex antigen with 11/26 having had a history of anaphylaxis to latex products. Twenty three of the 26 sera from skin-test positive patients and 10/11 patients with history of anaphylaxis demonstrated significant levels of latex specific IgE and IgG in the sera, whereas only 1/14 normals showed significant antibodies to latex. The remaining 10 patients, all skin-test negative with latex antigens, showed only low levels of antibodies. The findings indicate that the ELISA used in the present study employing partially characterized antigens has sensitivity and specificity to detect latex specific antibodies in the sera of suspected patients and can be used for presumptive diagnosis of latex allergy.

Allergens↗
PubMed2003

Comparative evaluation of Type 1 latex hypersensitivity in patients with chronic urticaria, rubber factory workers and healthy control subjects.

Latex hypersensitivity manifests itself most commonly with contact urticaria. In this study, we investigated the frequency of latex hypersensitivity as a possible aetiological factor in patients with chronic urticaria (CU) and compared latex hypersensitivity of CU patients (n = 50) with that of rubber factory workers (n = 50) and healthy controls (n = 50). Prick test with latex and fruit extracts and determination of latex-specific immunoglobulin E (IgE) were performed. As a risk factor, contact dermatitis due to rubber additives was tested by patch test. Latex hypersensitivity was detected in 14% of CU patients, 12% of rubber factory workers and 12% of healthy controls (P > 0.05). Positive patch test with rubber additives was detected in 6% of CU and 4% of rubber factory workers. 3 of 7 CU patients had sensitivity to fruits in addition to latex hypersensitivity. In 1 patient with CU, the clinical complaints were found to be related to latex hypersensitivity. These findings suggest that the frequency of latex hypersensitivity in CU patients is no higher than that in healthy individuals. However, CU patients should be carefully asked about latex allergy, as we demonstrated that 1 of the CU patients had undiagnosed symptomatic latex allergy.

Adult↗
PubMed1995

Comparison of latex hypersensitivity among patients with neurologic defects.

BACKGROUND: Latex hypersensitivity has been described in discrete populations including health care workers and children with spina bifida (SB). OBJECTIVE: This study was designed to determine whether the SB population is a unique neuroimmunologic group manifesting this sensitivity. METHODS: Four groups of subjects were studied. These included: 36 patients with SB with or without clinical evidence of latex hypersensitivity, 50 patients with spinal cord injury (SCI), and 10 patients with cerebrovascular accidents (CVAs), all of whom were questioned regarding contact with and possible clinical allergic reactions to latex. Ten healthy control subjects were also studied. We used a latex sap extract, previously shown to react with latex-specific IgE in a biotin-avidin ELISA, to determine latex-specific IgE antibody titers and to compare the groups. RESULTS: Responses to questionnaires indicated that neither the patients with SCI nor the patients with CVA had histories suggestive of latex hypersensitivity. In contrast, 72% of the SB population had histories of clinical latex allergy. Comparisons of latex contact among the SB, SCI, CVA, and control groups revealed that the SB and SCI groups had similar latex exposure, whereas the other groups had less exposure. Both the SB and SCI groups had an average of two surgical procedures per year, which was greater than the average for the other groups. Comparisons of IgE latex antibody titers among the groups indicated that only the SB group had significant levels. The mean optical density values for each group were: 0.299 +/- 0.177 for patients with SB and positive skin prick test results, 0.072 +/- 0.066 for patients with SB and negative skin prick test results, 0.098 +/- 0.005 in patients with SCI, 0.073 +/- 0.038 in patients with CVA, and 0.053 +/- 0.034 in control subjects. The percentages of positive latex IgE antibody detection were 72% for SB, 4% for SCI, 0% for CVA, and 0% for control groups. CONCLUSIONS: The results suggest that the SB population is unique in demonstrating IgE responses to latex contact, which may be due to increased latex exposure or altered neuroimmunologic interactions.

Adolescent↗
PubMed2001

Latex hypersensitivity in spinal cord injured adult patients.

Latex hypersensitivity is a major cause of anaphylaxis during anaesthesia. Patients with spina bifida, health care or rubber industry workers have been considered at risk for latex sensitization. By analogy, the existence of other at-risk subsets of patients with latex exposure due to frequent surgical procedures has been suggested. The aim of this study was to evaluate the prevalence of latex sensitization in a cohort of adult patients with spinal cord injury and repeated latex exposure. Forty-two adult patients with spinal cord injury were studied and retrospectively compared to a group of 30 children with spina bifida evaluated using a similar protocol. Patients were administered a questionnaire concerning history of latex hypersensitivity, atopy, and surgical procedures. Latex sensitivity was investigated by skin prick-tests and latex-specific IgE assay. The search for atopy was based on in vivo and in vitro tests against a panel of environmental allergens. No chronic spinal cord injured patient had a history of latex allergy. When compared with spina bifida, the number of surgical procedures was not statistically different. Although not significantly different, the prevalence of atopy was higher in spina bifida patients. The high level of latex sensitization in spina bifida patients contrasted sharply with the absence of sensitization observed on both skin and in vitro tests in patients with spinal cord injury (P<0.0001). This study confirms that adult patients with chronic neurologic defects resulting from spinal cord injury exhibit a low risk of latex sensitization. These results suggest that considering adult patients with repeated surgical procedures as a group at risk for latex sensitization because of a high degree of latex exposure should be re-examined.

Adolescent↗
PubMed1995

Latex hypersensitivity in children.

Latex is a natural substance used in the manufacture of thousands of products. Although latex allergy is uncommon in the general population, health care workers and children with spina bifida appear to be at high risk for latex allergy. These patients may experience urticaria, rhinoconjunctivitis, bronchospasm, and anaphylaxis following contact with or inhalation of latex antigens. Several protein allergens in latex have been identified, some of which appear to cross-react clinically and immunochemically with fruit antigens. Good diagnostic tests are available for latex allergy, but strict avoidance is still the only available treatment.

Asthma↗
PubMedDate not supplied

[Prevalence of latex hypersensitivity among medical personnel].

In order to determine the latex hypersensitivity prevalence in medical residents from Hospital Universitario de Puebla, it was carried out a transversal, observational and descriptive study including the medical staff of all specialties. The epicutancous test was effectuated with 1:20 latex antigen dilution. It was studied a total of 90 medical residents, 68.9% were males and 31.1% females. The mean age was 30.6 years (SD 3.8). The 50% were from clinical specialties and 50% else were from surgical. The global latex hypersensitivity prevalence was 8%. It will be convenient to carry out a follow up of studied cohort to establish if continual exposition, years later, will determine skin reactivity to latex in professional practice.

Adult↗
PubMedDate not supplied

Minimum prevalence of latex hypersensitivity in health care workers.

Health care workers (HCW) have been shown to be at significant risk for developing latex allergy. Natural rubber latex hypersensitivity has been reported in 2.9 to 17% of health care workers in previously published studies. This study describes the prevalence of latex hypersensitivity in a large cohort of medical center employees. A screening questionnaire was distributed to 1967 employees in six job categories exposed to latex, and 1331 questionnaires were returned (68%) between March and November 1995. Skin and serologic testing was performed on 156 volunteers. Of the 1331 HCWs who completed the screening questionnaire, 290 (21.8%) self-reported contact dermatitis to latex, 67 (5.0%) self-reported urticaria to latex, 163 (12.2%) self-reported rhinoconjunctivitis to latex, and 17 (1.3%) self-reported asthmatic symptoms to latex. Of the total population of 1967 employees, 38 (1.9%) were either skin test or blood test positive and 30 (1.5%) of these 38 were symptomatic around latex. This study suggests a minimum prevalence of IgE-mediated hypersensitivity to latex of 1.5% among medical center employees. Our reported prevalence figures are lower than previously reported, reflecting, in part, reporting methods using a denominator more consistent with the total population at risk. Our study also illustrates the pitfall of relying on self-reporting in making the diagnosis of latex allergy.

Cohort Studies↗
PubMed1995

Latex hypersensitivity in children: clinical presentation and detection of latex-specific immunoglobulin E.

OBJECTIVE: To better understand the clinical characteristics, diagnosis, and possible prevention of immediate hypersensitivity reactions to latex in a hospitalized, pediatric patient population. METHODS: We performed a retrospective case analysis of the first 35 patients with latex allergy evaluated by our service over a 2-year period at our institution. Characteristics of patients and clinical reactions were analyzed and the presence of latex-specific immunoglobulin E was assessed using in vitro methods. In a limited group of patients, the success of strict environmental control and premedication with steroids and antihistamines was evaluated for the prevention of latex allergic reactions. RESULTS: The majority of our patients had life-threatening reactions. In previous reports, most pediatric patients underwent reactions in the perioperative period and belonged to two well-recognized "high-risk" patient groups (spina bifida and genitourinary malformations). In our series, 21 patients (60%) had reactions outside of the operating room setting, and 14 patients (40%) had primary diagnoses outside of the previously recognized "high-risk" groups. Many patients had a history of multiple surgical procedures, and a history of a surgical procedure in the first year of life was very common. A pre-existing clinical history of latex allergy was present in only 18 of the 35 patients, and a severe or life-threatening allergic reaction was the presenting feature of latex allergy in 11 of the 35 patients. Using in vitro assays, we were able to detect latex-specific immunoglobulin E in the sera of all but two of our patients. Latex gloves and latex-containing intravenous sets were common triggers for reactions. When exposure to latex occurs systemically, as through an intravenous line, premedication with steroids and antihistamines may fail to protect against anaphylaxis. CONCLUSIONS: Our experience indicates that the incidence of latex hypersensitivity in children is increasing, that the circumstances (patient profile, hospital location, route of exposure) in which life-threatening reactions may occur are more broad than previously reported, and that a better understanding of both environmental sources of latex antigens and host responses to latex exposure are needed for improved prevention of serious reactions.

Adolescent↗
PubMedDate not supplied

Latex hypersensitivity reactions despite prophylaxis.

Latex rubber hypersensitivity represents a significant problem facing the medical, surgical, radiologic, and dental professions. As a tertiary care center, the Childrens Hospital of Philadelphia has a large population of patients with spina bifida and complex genitourinary anomalies; a number of these children have latex rubber allergy, which may first present as intraoperative anaphylaxis. Although there is no substitute for complete antigen avoidance, all medical products containing latex rubber may not have suitable alternatives. Therefore, we have formulated a protocol to prevent perioperative reactions through the use of prophylactic medications and the limitation of latex exposure. This regimen includes steroids, antihistamines, and bronchodilators when indicated. In four children, prophylaxis failed perioperatively because of parenteral infusion of latex rubber proteins.

Adolescent↗
PubMed2000

Latex hypersensitivity in a child with diabetes.

BACKGROUND: A 6-year-old girl who was diagnosed with diabetes mellitus 20 months previously developed erythematous, raised lesions at the site of her insulin injections. The reactions occurred when isophane and lispro insulin were administered individually or combined but not when insulin was obtained from the bottle after the septum had been removed. OBJECTIVES: To describe latex hypersensitivity in a child with diabetes and to review the literature. DESIGN: Case report. RESULTS: Findings from intradermal testing confirmed latex hypersensitivity. A change to insulin administration by insulin pen decreased the frequency of the reactions. CONCLUSION: Latex hypersensitivity should be considered in children with type 1 diabetes who develop local reactions to insulin injections.

Child↗
PubMed1993

[Latex hypersensitivity in children].

Latex (natural rubber), which is obtained from the Hevea brasiliensis tree, is known to cause contact urticaria and aggravate pre-existing atopic dermatitis. We present a 4.5 year-old boy with bladder exstrophy and epispadias who developed generalized urticaria and bronchospasm during general anesthesia prior to correction of the epispadias. He had undergone previous urologic operations uneventfully. Allergic evaluation revealed atopy with specific IgE antibodies against latex. Immediate skin tests performed with the medications given during the general anesthesia were negative, supporting the possibility that his anaphylactic reaction was caused by exposure to latex during intubation and ventilation. Similar cases have recently been described, especially in children with congenital urogenital abnormalities who are frequently exposed to latex (catheters, surgical gloves). Exposure to latex in these children should be minimized. In addition, they should be prepared with orally administered corticosteroids and antihistamine medication prior to operation.

Anaphylaxis↗
PubMed1999

Management of the latex hypersensitive patient in the endodontic office.

This case report documents the treatment of an endodontic patient who experienced a type 1 hypersensitivity reaction to latex. The dental, medical, and environmental aspects of treating latex allergic patients are reviewed. Because gutta-percha and latex rubber are similar compounds, the possible cross-reactivity of these materials is discussed.

Adult↗