Risk factors for latex sensitization in children with spina bifida

Abstract

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.

Risk factors for latex sensitization in young children with myelomeningocele

“…6,17,18,23 Variability of results can be related to differences in methodology, namely variables related to the population of the study (age group) or the diagnostic method (SPT or serum IgE testing and different methods of SPT). 3, 22,27 In our study, the results of SPT and latex-specific IgE testing were positive in 30 and 8% of patients, respectively, rates that are lower than those reported in most previous studies. As discussed, the young age of patients in our study (mean age 3.7 years) may account for the low prevalence of latex sensitization.…”

“…Mucosal contact during CIC promotes sensitization 27 and is considered a potential risk factor for latex sensitization in MMC. 3 The use of CIC has not been found as a risk factor for latex sensitization in other studies, 3,7,10,27 except for 1 study in which the presence of CIC but not the duration of CIC emerged as a significant factor.…”

Latex Allergy within a Cohort of Not-at-Risk Subjects with Respiratory Symptoms: Prevalence of Latex Sensitization and Assessment of Diagnostic Tools

“…Immunoglobulin E (IgE)-mediated hypersensitivity to natural rubber latex (NRL) is a major clinical problem in allergy and is often encountered in pediatric subjects undergoing repeated surgical procedures, such as those affected by spina bifida [1] and urogenital abnormalities [2], as well as in health care workers (HCW) and rubber industry workers as an occupational condition [3]. Sensitization may occur by wound exposure, by skin or mucosal contact, or inhalation of allergens from NRL-containing products.…”

“…The prevalence of sensitization to NRL is about 2–17% among exposed HCW, up to 30–50% in childhood patients with spina bifida [1, 5], but less than 1% in the general childhood [6] and adult [7] population. The prevalence of NRL allergy is actually lower, because some individuals sensitized to NRL, as assessed by in vivo and in vitro testing, do not have evident clinical symptoms [8].…”

Identificação dos fatores associados à sensibilização e alergia ao látex em pacientes com defeito de fechamento do tubo neural

“…A presença de hidrocefalia sempre deve ser avaliada e, quando indicado, a derivação ventrículo-peritoneal (DVP) deverá ser instalada (Fernandes et al, 2007). É comum a realização de outros procedimentos, o que constitui um dos fatores descritos como responsáveis para que os pacientes com DFTN sejam o maior grupo de risco para alergia ao látex (Pires et al, 2002).…”