A cluster of anaphylactic reactions in children with spina bifida during general anesthesia: Epidemiologic features, risk factors, and latex hypersensitivity

Kelly, Kevin J.; Pearson, Michell L.; Kurup, Viswanath P.; Havens, Peter L.; Byrd, Robert S.; Setlock, Mary A.; Butler, Jay C.; Slater, Jay E.; Grammer, Leslie C.; Resnick, Abe; Roberts, Mary; Jarvis, William R.; Davis, Jeffrey P.; Fink, Jordan N.

doi:10.1016/0091-6749(94)90071-x

Cited by 192 publications

(88 citation statements)

References 25 publications

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“…The age of these children (most of them younger than 5 years old) can justify the prevalence of sensitization in our study, as well as the small number of symptomatic children (12 %). In the studies involving children older than 7.5 years (5,6,28,29,32,33,38,41), the prevalence of latex allergy was higher, varied between 24 % and 63 %. In the available studies, none of the works included children with an average age under that observed in our study.…”

Section: Discussionmentioning

confidence: 97%

“…Besides latex exposure during surgical interventions, atopy is considered by the majority of authors as the most important risk factor for latex sensitization in patients with spina bifida (7,29,30,37,40,41), as well as for latex allergy (5,32,37,41,52). Moneret-Vautrin et al (30), suggest the possibility of a synergetic effect resulting from the combination of these two factors towards promoting sensitization.…”

Section: Discussionmentioning

confidence: 99%

“…Swert et al (52), studying patients with and without latex allergy, diagnosed by challenge test (surgical glove band in the arm) matched by age, gender and number of surgeries, found that the geometric average of total IgE was significantly higher in allergic patients. Kelly et al (32), in a population of 60 children with spina bifida, identified total IgE > 84 IU/ml as a risk factor for anaphylactic reaction during surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Several published studies found prevalences between 4.3 % and 73.3 % (table I) (5)(6)(7)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). The variability of results can be related with differences in the methodology, namely variables related with the population in study (dimension and age group) or the diagnostic method (SPT and/or serum IgE determination, absence of allergenic extract standardization and different methodology of SPT).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for latex sensitization in children with spina bifida

Pires

Morais‐Almeida

Gáspár

et al. 2002

Allergologia et Immunopathologia

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SUMMARYBackground: Children with spina bifida represent the major risk group for latex sensitization.Purpose: To determine the prevalence of latex sensitization in these children and to identify risk factors.Material and methods: We studied 57 patients with spina bifida. The mean age was 5.6 years and the male/female ratio was 0.8/1. In all patients a questionnaire, skin prick test (SPT) with latex (UCBStallergènes, Lofarma and ALK-Abelló), common aeroallergens and fruits (UCB-Stallergènes) and serum determination of total IgE (AlaSTAT) were performed.Results: The prevalence of latex sensitization was 30 %; only two sensitized children (12 %) had symptoms after exposure. Risk factors for latex sensitization were age Ն 5 years (p = 0.008; OR = 6.0; 95 % CI = 1.7-22.1), having at least four previous surgical interventions (p < 0.0001; OR = 18.5; 95 % CI = 3.6-94.8), having undergone surgery in the first 3 months of life (p = 0.008; OR = 5.4; 95 % CI = 0.7-29.2) and total serum IgE Ն 44 IU/ml (p = 0.03; OR = 3.8; 95 %CI = 1.1-13.1). Multiple logistic regression analysis showed that only a history of four or more surgical interventions (p < 0.0001; OR = 26.3; 95 %CI = 2.9-234.2) and total serum IgE Ն 44 IU/ml (p = 0.02; OR = 8.6; 95 % CI = 1.4-53.4) were independently associated with latex sensitization. Sex, family and personal allergic history, hydrocephalus with ventriculoperitoneal shunt, cystourethrograms, intermittent bladder catheterization and atopy were not related to latex sensitization. Conclusions:In children with spina bifida, significant and independent risk factors identified for latex sensitization were multiple interventions and higher levels of total serum IgE. A prospective study will clarify the clinical evolution of assymptomatic children sensitized to latex.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for latex sensitization in children with spina bifida

Pires

Morais‐Almeida

Gáspár

et al. 2002

Allergologia et Immunopathologia

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“…Although food and venom are well recognized causes of anaphylaxis, [1][2][3][4]12,13 the role of latex in this regard deserves emphasis. 5,14 Not only was latex the single most common causative agent in our study population, it was often overlooked in this role. In several cases of recurrent latex-related anaphylaxis, it was initially thought that parenterally administered antibiotics were the causative agents.…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis in Children: A 5-Year Experience

Dibs

Baker

1997

Pediatrics

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ABSTRACT. Objectives. To identify the causative agents, presenting signs and symptoms, and course of disease in children diagnosed with anaphylaxis.Design. Five-year retrospective chart review. Setting. Urban children's hospital pediatric emergency department, operating suite, and inpatient units.Participants. Fifty-five cases of anaphylaxis in 50 patients 1 to 19 years of age.Interventions. None. Results. The most common inciting agents in this population were latex (27%), food (25%), drugs (16%), and venoms (15%). Thirty-two cases (58%) occurred outside of the hospital, including 3 of 11 severe cases. Nineteen (35%) had histories of prior allergy to the causative agent. Most agent exposures were intravenous (38%), oral (27%), or dermal (20%). The most common systems involved were respiratory (93%), skin (93%), cardiovascular (26%), and neurologic (26%). Features distinguishing the 11 patients requiring intensive care included latex agents (45%), nonenteral route of exposure (91%), and presence of cardiovascular symptoms (45%). Of the 17 patients with known past anaphylaxis, only 5 had epinephrine self-administration devices available, and 3 had used them.Conclusions.

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Natural Rubber Latex Allergy

Brehler¹,

Kütting²

2001

Arch Intern Med

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In the past 10 years, IgE-mediated allergy to natural rubber latex has become a significant health problem in industrialized countries, especially among health care workers, patients with congenital malformations, and children with a history of multiple surgical interventions. Curative treatment inducing immunological tolerance in formerly sensitized patients is experimental and not yet generally available. Therefore, it is important to be aware of the seriousness of latex allergy and to understand the risk factors leading to this allergy. Preventive measures are needed to decrease the incidence of natural rubber latex sensitization. This article gives a brief review of the current state of knowledge concerning latex allergy, including a definition of latex, epidemiological data, identified allergens, the clinical spectrum, diagnostic procedures, cross-reactions, preventive measures, the legislative background, and economics.

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A cluster of anaphylactic reactions in children with spina bifida during general anesthesia: Epidemiologic features, risk factors, and latex hypersensitivity

Cited by 192 publications

References 25 publications

Risk factors for latex sensitization in children with spina bifida

Risk factors for latex sensitization in children with spina bifida

Anaphylaxis in Children: A 5-Year Experience

Natural Rubber Latex Allergy

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