Frequency of natural rubber latex allergy in adults is increased after multiple operative procedures

Ruëff, Franziska; Kienitz, A; Schöpf, Pia; Wh, Hartl; Hj, Andress; Zaak, D; Menninger, M; Przybilla, Bernhard

doi:10.1034/j.1398-9995.2001.00021.x

Cited by 38 publications

(17 citation statements)

References 38 publications

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“…Studies conducted in adult patients with a condition other than myelomeningocele demonstrated that having more than 10 surgeries was significantly associated with latex allergy (p < 0.001). 17 The most significant data obtained from this study is that having more than five surgeries was a risk factor associated with latex allergy in this population. The same number of surgeries was also observed by Michael, et al, who assessed a population of German children with myelomeningocele.…”

Section: Discussionmentioning

confidence: 79%

“…In addition, different authors have stated that spina bifida itself is an independent risk factor for latex allergy. 16,17 It has been demonstrated that the number of surgeries, especially in the first year of life, is the most important risk factor for sensitization and it is directly related to higher levels of latexspecific IgE. 6,16 Degenhardt, et al 16 assessed 86 patients (mean age: 10.2 years old) with a history of gastrointestinal or urological surgical procedures and found that having more than eight surgeries in the first year of life significantly increased the risk of latex allergy.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of latex allergy in a population of patients diagnosed with myelomeningocele

et al. 2016

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Introduction:Latex allergy is one of the main reasons of anaphylaxis in the operating room. The prevalence of this condition is higher among patients with myelomeningocele. Epidemiological data obtained from Argentine patients is scarce. Objective: To estimate the prevalence of latex sensitivity and latex allergy in a population of patients with myelomeningocele and to describe associated risk factors. Population and Methods: Descriptive, crosssectional, observational study. Family and personal history of allergy, number of surgeries, history of symptoms caused by having been in contact with latex or cross-reactive foods, eosinophil count, measurement of total immunoglobulin E and specific immunoglobulin E levels by means of skin and serologic testing for latex, aeroallergens and cross-reactive fruit. Results: Eighty-two patients diagnosed with myelomeningocele were assessed: 41 were males and their average age was 15.3 ± 7.66 years old. Out of all patients, two did not complete skin and serologic testing. Among the remaining 80 patients, 16 (19.51%) had latex allergy, 46 (57.5%) were not allergic, and 18 (22%) showed sensitivity but not allergy. Having undergone more than five surgeries was a risk factor associated with latex allergy (p= 0.035). No significant association was observed with the remaining outcome measures. Conclusion: According to this study, the prevalence of latex allergy in this population of patients is 19.51% and the most important risk factor for this condition is a history of having undergone more than five surgeries.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Prevalence of latex allergy in a population of patients diagnosed with myelomeningocele

et al. 2016

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“…Children with spina bifida have a particularly high rate of latex sensitization, with a prevalence of 37% reported in Australia [34], 40% in Europe [35] and 60% in the United States [36]. The experience of multiple surgical procedures exposes these children to a range of rubber products from an early age [37] and is a risk factor for latex allergy [11,12,15] (Table 1). Although efforts to reduce latex exposure during surgery have [25,26] reduced sensitization, especially to proteins of dipped latex products [38,16], the frequent use of in-dwelling catheters may continue to expose these children to the latex proteins of solid rubber products.…”

Section: Latex Allergy -Evolution Of An Epidemic and Beyondmentioning

confidence: 96%

Latex allergy: a model for therapy

Rolland

O’Hehir

2008

Clin Experimental Allergy

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Allergy to natural rubber latex products emerged as an important clinical condition following an increase in the use of latex gloves for barrier protection in the early 1980s. In addition to latex glove users, other high-risk groups with different latex exposure include spina bifida patients and others with multiple surgical procedures. Subjects with fruit and vegetable allergy are also at risk due to cross-reactive allergens. Following the significant advances in the identification and characterization of common aeroallergens, latex allergy was well placed to become an excellent model of therapy. Awareness of latex allergy and modes of sensitization enabled epidemiological studies to inform allergen avoidance initiatives, substantially reducing inadvertent exposure in major hospitals in Western countries. Spina bifida is often identified in utero or soon after birth, allowing vigorous latex allergen avoidance with enhanced efficacy of primary prevention. However, changing demographics of latex allergy and technological revolution in countries such as China and India are predicted to unleash a second wave of latex allergy reemphasizing the incentive for improved manufacturing procedures for latex products. The desirable high tensile strength and elasticity of natural rubber latex have made the commercial identification of good alternatives very difficult but this would also be attractive for primary prevention. In addition, an effective specific immunotherapy regimen would be valuable for selected high-risk atopic individuals. Current subcutaneous and sublingual immunotherapy schedules have been tested for treatment of latex allergy with evidence of efficacy but the risks of adverse events are high. For such potent allergens as latex, hypoallergenic but T cell-reactive preparations are required for clinical use. Identification of allergenic components of latex products, with generation of monoclonal antibodies and recombinant allergens, allowed sequence determination and mapping of T cell and B cell epitopes. Together, these reagents and data facilitated improved diagnostics and investigation of novel-specific therapeutics. Potential hypoallergenic latex preparations identified include modified non-IgE-reactive allergen molecules and short T cell epitope peptides. The co-administration of adjunct therapies such as anti-IgE or corticosteroids and of appropriate adjuvants for induction of regulatory T cell response offers promise for clinically effective, safe latex-specific vaccines.

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“…The correlation of repeated surgeries and latex sensitization was described in several studies [28,[75][76][77][78]. The principles of a latex prophylaxis programme were published by the Task Force on Allergic Reactions to Latex in 1993 ( Table 2) at the American Academy of Allergy and Immunology [23].…”

Section: Effects Of Latex Prophylaxismentioning

confidence: 99%

Natural Rubber Latex Allergy in Pediatric Patients

Cremer¹,

Rihs²,

Raulf‐Heimsoth³

2008

CPR

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During the last fifteen years better hygienic standards led to an increased consumption of natural rubber latex (NRL) gloves for the protection of medical staff. At the same time case reports about an IgE-mediated allergy to NRL sometimes causing life-threatening anaphylactic reactions came up. This allergy was different from the well-known type IV reactions caused by latex additives. Health care workers and patients with multiple surgery surgeries were identified as high risk groups. For unknown reasons patients with spina bifida (SB) showed the highest prevalence of NRL-specific IgE-antibodies. A pre-existing atopy increased the risk of latex sensitization. Allergic reactions were caused mainly by medical procedures, especially surgeries, if latex gloves and other latex containing devices were used.Meanwhile some allergenic proteins in NRL (named Hev b in accordance with the rubber tree Hevea brasiliensis) could be identified. Patients in different risk groups showed distinct prevalences of sensitization to these allergens. The way of the allergen uptake (aerogen or by direct mucosal contact during surgeries) played an important role in the sensitization to different allergens. Most of the latex allergens like Hev b 1, Hev b 3, Hev b 6.02 have been totally sequenced. Since the sequence of all registrated allergens (Hev b 1 -Hev b 13) is known, it was possible to localize in Hev b 1, Hev b 5 and Hev b 6.01 several IgE binding sites as well as T cell epitopes.Cross-reacting antibodies between NRL and numerous fruit were described and for some proteins structural homologies were well characterized.For the in vitro diagnosis of NRL allergy serologic tests with improved extracts and recombinant allergens (for instance ImmunoCAP TM system) are available. NRL protein extracts for skin prick tests were difficult to standardize. The use of natural extracts in combination with recombinant latex allergens could be one possible future perspective for skin testing.The problem of NRL allergy is still not resolved but significant progress has been made in its prevention. In high risk patients like persons with spina bifida a primary prophylaxis was performed with success, but also secondary or tertiary prophylaxis allows safe operations without symptoms of NRL allergy.

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Frequency of natural rubber latex allergy in adults is increased after multiple operative procedures

Abstract: A remarkable percentage of unselected adult patients undergoing surgical procedures have allergy or sensitization to NRL. Repeated invasive treatment appears to be a risk factor for NRL allergy.

Cited by 38 publications

References 38 publications

Prevalence of latex allergy in a population of patients diagnosed with myelomeningocele

Prevalence of latex allergy in a population of patients diagnosed with myelomeningocele

Latex allergy: a model for therapy

Natural Rubber Latex Allergy in Pediatric Patients

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