Latex Allergy in Children with Spina bif ida

Abstract

We studied the prevalence of latex-specific IgE among the children in our myelomeningocele clinic and several groups of controls using skin tests, a commercially available ELISA and an in-house RAST. Thirty-nine of 83 (47%) children with myelomeningocele had antibodies directed against latex as did 6 of 40 (15.7%) chronically ill controls, 4 of 105 (3.8%) medical controls and 2 of 75 (2.7%) well controls. Within each study group the likelihood of a positive skin test increased with the number of operations the subject had undergone. Children with myelomeningocele were much more likely to have antibodies to latex than were chronically ill controls with similar surgical histories. A retrospective chart review of 18 years and a total of 646 operations disclosed only one episode of intraoperative anaphylaxis which appeared to be related to latex within our study group.

Risk factors for latex sensitization in children with spina bifida

“…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.…”

“…Demographic data, such as age (37,40) and gender (6), contact with latex products, including number of surgical interventions (7,29,30,33,37,(39)(40)(41)(42)(43) performing cystourethrograms and bladder catheterization (37), existence of hydrocephalus with ventriculoperitoneal shunt (37,41,49), atopy (7,29,30,37,40,41), fruit sensitization (7) and high levels of total IgE (7, 37) have been identified as risk factors. Some of these characteristics are related to each other.…”

“…There are few studies performing logistic regression analysis, allowing the identification of significant and independent risk factors (7,37,40). The importance of a high number of surgeries in latex sensitization was documented in most studies (7,29,30,33,37,(39)(40)(41)(42)(43), although the value from which there is a risk is not usually mentioned. Bernardini et al (7), in a population of 59 patients with spina bifida, identified 5 or more surgical interventions as a risk factor.…”

“…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).…”

“…The high prevalence of sensitization seems to be a result, mainly, of early (33,34,(39)(40)(41) and frequent contact with latex products (7,29,30,33,37,(39)(40)(41)(42)(43). The exposure begins, frequently, in the first day of life, with myelomeningocele surgical closure, and continues during several surgical procedures to correct neurologic, urologic and orthopedic congenital malformations.…”