Latex allergy in spina bifida patients – prevention by primary prophylaxis

Cremer, Reinhold; Kleine‐Diepenbruck, U.; Hoppe, A.; Bläker, F

doi:10.1111/j.1398-9995.1998.tb03958.x

Cited by 80 publications

(35 citation statements)

References 11 publications

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“…Cremer et al (55), in a pioneer study, recently, demonstrated that primary prevention could avoid the appearance of latex sensitization in children with spina bifida. The authors performed a prospective study with 2 years of duration, involving 12 newborns with spina bifida, which underwent surgery in a latex-free environment since the first day of their lives, verifying that none of these children were sensitized.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for latex sensitization in children with spina bifida

Pires

Morais‐Almeida

Gáspár

et al. 2002

Allergologia et Immunopathologia

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SUMMARYBackground: Children with spina bifida represent the major risk group for latex sensitization.Purpose: To determine the prevalence of latex sensitization in these children and to identify risk factors.Material and methods: We studied 57 patients with spina bifida. The mean age was 5.6 years and the male/female ratio was 0.8/1. In all patients a questionnaire, skin prick test (SPT) with latex (UCBStallergènes, Lofarma and ALK-Abelló), common aeroallergens and fruits (UCB-Stallergènes) and serum determination of total IgE (AlaSTAT) were performed.Results: The prevalence of latex sensitization was 30 %; only two sensitized children (12 %) had symptoms after exposure. Risk factors for latex sensitization were age Ն 5 years (p = 0.008; OR = 6.0; 95 % CI = 1.7-22.1), having at least four previous surgical interventions (p < 0.0001; OR = 18.5; 95 % CI = 3.6-94.8), having undergone surgery in the first 3 months of life (p = 0.008; OR = 5.4; 95 % CI = 0.7-29.2) and total serum IgE Ն 44 IU/ml (p = 0.03; OR = 3.8; 95 %CI = 1.1-13.1). Multiple logistic regression analysis showed that only a history of four or more surgical interventions (p < 0.0001; OR = 26.3; 95 %CI = 2.9-234.2) and total serum IgE Ն 44 IU/ml (p = 0.02; OR = 8.6; 95 % CI = 1.4-53.4) were independently associated with latex sensitization. Sex, family and personal allergic history, hydrocephalus with ventriculoperitoneal shunt, cystourethrograms, intermittent bladder catheterization and atopy were not related to latex sensitization. Conclusions:In children with spina bifida, significant and independent risk factors identified for latex sensitization were multiple interventions and higher levels of total serum IgE. A prospective study will clarify the clinical evolution of assymptomatic children sensitized to latex.

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Section: Discussionmentioning

confidence: 99%

Risk factors for latex sensitization in children with spina bifida

Pires

Morais‐Almeida

Gáspár

et al. 2002

Allergologia et Immunopathologia

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“…The use of powder-free gloves with decreased protein content especially led to a great reduction in airborne latex allergen [53] . Initiation of a primary NRL prophylaxis program around and during surgery, as well as anesthesia of all spina bifida patients, had a beneficial effect on the reduction of NRL sensitization [54] . The latest data finally show that in children with spina bifida who grew up completely latex-free from birth on, sensitization to NRL was 5% in comparison to 55% for a former non-latex-free group, and clinically relevant allergy decreased significantly from 37 to 1% [55] .…”

Section: Preventive Measures -Successful Avoidance Strategymentioning

confidence: 99%

The Latex Story

Raulf

2014

History of Allergy

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The milky sap of the rubber tree Hevea brasiliensis is the source of the commercial production of natural rubber latex (NRL) devices, and also represents a source of potent allergenic proteins. NRL materials were introduced in the health care field in about 1840 with the advent of technical abilities to produce suitable and flexible NRL materials for medical products, especially gloves. In the late 1980s, with the increase of transmittable diseases, particularly HIV infection, the use of NRL gloves increased dramatically. During the 1990s, NRL emerged as a major cause of clinically relevant allergy in health care workers using NRL gloves and spina bifida patients with operation on the first day. The increased recognition of NRL allergies, the enhanced research on allergen characterization and sensitization mechanisms, and education about this allergy in health care facilities combined with the introduction of powder-free gloves with reduced protein levels are all factors associated with a decline in the number of suspected cases of NRL allergies in the late 1990s. NRL allergy is a very good example of a 'new allergy' that suddenly arises with tremendous health and economic implications, and also of an allergy which becomes history in a relatively short period of time based on successful primary prevention strategies by strict allergen avoidance.

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“…4 The same authors observed no new sensitization after having established latexfree surgery and anesthesia. 5 Our study considers three time points.…”

Section: Latex Allergy In Spina Bifida: At the Turning Point?mentioning

confidence: 99%