Natural rubber latex allergy: prevalence and risk factors in patients with spina bifida compared with atopic children and controls

Abstract

Type 1 allergy against natural rubber latex is an increasing problem in health care workers and children with spina bi®da or urogenital malformations. The aim of our study was to evaluate the prevalence of latex IgE antibodies and cross-reacting fruit antibodies in patients with spina bi®da compared with atopic and non-atopic controls. Risk factors for sensitization should be determined. Sera of 148 patients with spina bi®da and 98 controls (44 with atopy) were screened for IgE antibodies against latex, banana and kiwi by¯uorescence enzyme immunoassay (CAP system). Atopies, allergic symptoms after latex contacts and the number of operations were compiled by a questionnaire. Patients with spina bi®da developed latex IgE antibodies (!0.7 kU/l) more frequently (40.5%) than atopic children (11.4%) or healthy controls (1.9%). All 18 symptomatic patients belonged to the spina bi®da group and had high values of latex antibodies. The risk for developing latex antibodies increases with the number of operations. There was no dierence in the history of atopic diseases and in a screening test of IgE antibodies against inhalative allergens between latex sensitized and not sensitized children with spina bi®da. Antibodies against banana were more frequent in the latex sensitized children with spina bi®da. (18.3% vs 3.4%, P = 0.002). Conclusion The high prevalence of latex antibodies in children with spina bi®da justi®es a primary prophylaxis by avoiding latex contacts, especially during anaesthesia and surgery, a correlation between the number of operations and the development of latex antibodies exists.

Risk factors for latex sensitization in children with spina bifida

“…In this population, although the atopic children present a sensitization prevalence of 50 %, vs 24 % in non-atopics, this difference had no statistical significance. Also Cremer et al (6), in a study with 148 patients, with a similar prevalence of atopy (18.4 %), concluded that this was not a risk factor for latex sensitization. Capriles-Hulett et al (35), also did not find a relationship between latex sensitization and atopy.…”

“…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.…”

“…Most reactions are mild, but more serious and potentially lethal situations can occur, with systemic involvement, namely during surgical and diagnostic procedures with mucosal exposure to latex products (2)(3)(4). In spite of the diversity of symptoms, in some studies most sensitized individuals are assymptomatic (5)(6)(7)(8).…”

“…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).…”

Characterization of T Cell Responses to Hev b 3, an Allergen Associated with Latex Allergy in Spina Bifida Patients

“…Especially persons who are frequently exposed to NRL products suffer from hypersensitivity to latex allergens, causing allergic reactions including contact-urticaria, rhinoconjunctivitis, asthma, and even anaphylaxis (1)(2)(3). It has been reported that 2.8 -8.8% of all health care workers and 29 -72% of patients suffering from spina bifida (SB) are allergic to Hevea latex proteins (1)(2)(3)(4)(5)(6)(7). In the latter case, multiple surgeries and the frequent use of NRLcontaining instruments like catheters have been regarded as the cause for the sensitization.…”