Natural rubber latex allergy in children who had not undergone surgery and children who had undergone multiple operations.

Abstract

Children with spina bifida and other children requiring multiple surgical procedures represent a well-known risk group for natural rubber latex allergy. Children not undergoing surgery can also be sensitized, but findings in this group of children with latex allergy have not been thoroughly examined. We sought to examine the frequency of latex allergy in a large group of children admitted for inhalant or food allergy testing for the purpose of collecting information on a series of children with latex allergy and comparing the symptoms and findings between those not undergoing surgery and those undergoing multiple operations. Children admitted to the allergy laboratory of Tampere University Hospital were screened by skin prick tests (SPTs) with latex glove extract. All children with allergy as determined by the screening or admitted because of suspected latex allergy were reexamined from 1995 to 1996. For a definite diagnosis of latex allergy, positive SPT, latex RAST, and latex glove use test results were required. From 1992 to 1995, a total of 3269 children were skin prick tested with latex glove extract, and 55 (1.7%) had a positive response. On reexamination, 37 (1.1%) children had positive responses to SPTs, and 33 (1.0%) were confirmed to have latex allergy by means of RASTs and latex glove use tests. Since 1988, we have identified a total of 30 children with latex allergy who had not undergone surgery and 12 who underwent multiple operations. The clinical histories were similar in both groups; the mean ages at diagnosis were 5.7 and 8.1 years, and the frequency of atopy was 97% and 83%, respectively. Symptoms had occurred in 63% of the children who had not undergone surgery and in 75% of the children who underwent multiple operations. Contact urticaria was the most frequent symptom, and only one child had intraoperative anaphylaxis. Balloons, followed by gloves, were the most common latex products causing symptoms. The children with latex allergy who had not undergone surgery and those who underwent multiple operations showed no significant differences in SPT responses to commercial latex allergen extract or in specific IgE levels. The prevalence of latex allergy among children admitted for inhalant or food allergy testing was 1%. Although multiple operations at an early age are a well-known risk factor for latex allergy, the majority of children with latex allergy identified at screening or admitted because of suspicion of latex allergy belonged to the group of children who had not undergone surgery. One third of all the children studied were free of symptoms, indicating that screening with SPTs can be a valuable tool for detecting occult latex allergy in children.