latex allergy pathophysiology

The third, most serious, and least common syndrome is immediate (type I) hypersensitivity. 23(2):205-19. Essential in the workup of latex allergy is the clinical history. Sensitization to latex proteins depends on the amount and duration of exposure and the predisposition to atopy, and it is defined as identification of specific IgE antibody to latex proteins, with or without clinical symptoms. Latex-allergic persons have had oral symptoms of itching, swelling, and anaphylaxis with exposures to avocado, banana, and chestnuts. 2012 Aug. 78(8):868-78. Institutional policies and manufacturing efforts are helping to decrease latex exposure, sensitization, and, ideally, latex allergy. [22] Patients with spina bifida may have a genetic predisposition for latex sensitization. Int Arch Allergy Immunol. 2015 Sep. 11 (9):977-92. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Allergy to natural rubber latex is common and serious in children and adults. Intern Med. This action activates the cells to release preformed mediators, such as histamine, which cause immediate clinical symptoms of allergy, notably sneezing and itching. 2012 Dec. 69(12):925-31. Latex specific IgE: performance characteristics of the IMMULITE 2000 3gAllergy assay compared with skin testing. [Medline]. Hamilton RG, Biagini RE, Kreig EF: Diagnostic performance of Food and Drug Administration–cleared serologic assays for natural rubber latex–specific IgE antibody. National Institute for Occupational Safety and Health (NIOSH): NIOSH alert: Preventing allergic reactions to natural rubber latex in the workplace. 156(3):234-46. 1998 Aug. 28(8):971-6. [Docket No. Allergol Int. Taylor JS, Erkek E. Latex allergy: diagnosis and management. Powdered latex examination gloves have been the most frequent source of sensitization in adults, causing cutaneous and inhalational exposures, most often affecting the HCWs wearing them. Extensive studies performed at the Mayo Clinic demonstrate high levels of latex aeroallergens in operating rooms on days when many powdered latex gloves were used in the area, in contrast to minimal levels of airborne latex on weekend days and holidays when no gloves were used.6 This information has led to intervention policies to decrease levels of latex in operating rooms and hospitals. Occup Environ Med. Latex allergy is a reaction to certain proteins found in natural rubber latex, a product made from the rubber tree. J Allergy Clin Immunol. J Pediatr Urol. Irritant contact dermatitis will result in erythema of the skin, whereas allergic contact dermatitis is due to a delayed-type IV hypersensitivity reaction. Cross-reacting antigens have been found between these tropical fruits and latex. The two most common methods used to identify specific IgE antibody are the percutaneous (prick) skin test and radioallergosorbent test (RAST). Kelly KJ, Wang ML, Klancnik M, Petsonk EL. for: Medscape. Clarification of symptoms that occur with exposure to latex gloves and with other common latex products, such as latex balloons or condoms, is critical. [Medline]. Reports of outcomes of latex-allergic health care workers show that nonpowdered latex gloves, low-allergen latex gloves, and nonlatex gloves allow some health care workers with latex allergy to continue to work with lessened clinical symptoms in latex-safe environments.11,12. Dermatol Ther. Goldberg H, Aharony S, Levy Y, Sivan B, Baniel J, Ben Meir D. Low prevalence of latex allergy in children with spinal dysraphism in non-latex-free environment. [2, 23, 24] Workers with occupational exposure during harvesting and/or processing latex in developing countries where H brasiliensis is grown have an increased risk relative to the general populations. Occupational contact allergy caused by rubber gloves--nothing has changed. Latex proteins vary in their allergenic potential. [12, 13, 14] It can be fatal without emergent treatment. Dev Med Child Neurol. Pak VM, Watkins M, Green-McKenzie J. Symptoms generally begin within minutes of exposure. Blanco C, Carrillo T, Ortega N, Alvarez M, Dominguez C, Castillo R. Comparison of skin-prick test and specific serum IgE determination for the diagnosis of latex allergy. http://www.cdc.gov/Niosh/latexalt.html#sum. Beezhold DH, Sussman GL, Liss GM, Chang NS: Latex allergy can induce clinical reactions to specific foods. 17(4):289-301. 2007 Apr-Jun. See All About Allergies: Be Ready for Spring, a Critical Images slideshow, to help identify a variety of allergens and symptoms. Marmo M, Sacerdoti C, Di Minno RM, Guarino I, Villani R, Di lorio C. Anaphylactic shock during hyperbaric oxygen therapy. [Full Text]. 2015 Sep 24. Mark Louden, MD is a member of the following medical societies: American College of Emergency PhysiciansDisclosure: Nothing to disclose. Allergic contact dermatitis from latex gloves requires lymphocyte sensitization to chemical additives or accelerators that are used in the manufacturing process. It is now known that latex allergens bind to cornstarch powder used in glove manufacturing and that significant levels of airborne latex proteins are found in medical and dental offices. Hypersensitivity reactions during anesthesia. Filon FL, Radman G. Latex allergy: a follow up study of 1040 healthcare workers. 21(6):459-65. Contact Dermatitis. 1050166-overview 89(7):1024-8. [Medline]. Int J Immunopathol Pharmacol. [Medline]. Bernstein DI, Karnani R, Biagini RE, et al: Clinical and occupational outcomes in health care workers with natural rubber latex allergy. Diagnostic value of three different latex extracts. [Medline]. J Occup Environ Med. J Allergy Clin Immunol 2002;110:S70-S74. These reactions occur without an immunologic mechanism. 2011 Aug. 53(8):934-40. Latex is the milky fluid derived from the lactiferous cells of the rubber tree, Hevea brasiliensis. A pertinent history for symptoms related to latex exposures, tests to confirm the presence of IgE antibody, are necessary determine latex allergy. What is the role of thiurams in allergy to natural rubber latex products?. J Allergy Clin Immunol 2003;111:985-994. Type IV hypersensitivity is more common in atopic individuals. Their immune system reacts to latex as if it were a harmful substance. Poley GE, Slater JE: Latex allergy. Deaths have been reported following the intraoperative or procedural use of latex devices. J Allergy Clin Immunol 2002;110:S96-S106. (Fortunately, their use is decreasing as many hospitals move toward powder-free, "low-allergen," or nonlatex glove products.) More severe symptoms are bronchospasm, hypotension, and anaphylaxis. Latex allergy is among the most common causes of anaphylaxis in the operating room and has increased in prevalence with the increased use of latex gloves to prevent transmittable infections starting in the 1980s. Prevention of allergic reactions in anesthetized patients. 2003 May. Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital. The highest prevalence of latex allergy (20-68%) has been reported in patients with spina bifida or congenital urogenital abnormalities. Protein content varies with harvest location and manufacturing process. PATHOPHYSIOLOGY OF LATEX ALLERGY. 2015 Sep 5. [Medline]. Manufacturers of medical and commercial products have responded by labeling latex products and by developing latex-free items. Allmers H, Brehler R, Chen Z, Raulf-Heimsoth M, Fels H, Baur X. Expert Rev Clin Immunol. When the protective barrier of the skin is weakened by contact dermatitis, latex … Skin testing to identify latex-specific IgE antibody is convenient, sensitive, and fast. Please confirm that you would like to log out of Medscape. Thiurams, carbamates, and benzothiazoles can be confirmed as allergens by patch testing.5. Latex allergy is increased in populations with chronic occupational exposure to latex. Signs and symptoms of latex allergy depend on the type of latex product, the route of exposure, the amount of latex proteins, and the level of individual allergic sensitivity. Am J Ind Med. [Medline]. [Medline]. 2004 Jun. Latex Allergy. Sensitization is more common in atopic individuals. Kelly KJ, Kurup VP, Reijula KE, Fink JN: The diagnosis of latex allergy. It is not immune mediated, is not associated with allergic complications, and is not the subject of this article. Latex exposure is associated with 3 clinical syndromes.