[Immediate allergic reaction to natural latex with special reference to surgical gloves]

There is an increasing incidence of contact urticaria (CU) and systemic reactions to rubber products. 34 patients are presented: Most were atopic (22/34) and women (29/34). 24 worked in the medical field. 13 patients showed signs of hand dermatitis. In 31 patients, rub and/or pricktests with liquid latex in different dilutions and with latex gloves led to positive reactions. The allergen(s) appear in part to be watersoluble: 23 of 31 patients revealed positive test reactions to an aqueous glove extract. In two patients, urticarial test reactions to TMTD, Mercapto-Mix, and PPD-mix were considered as possible contributing factor of CU. Scratch tests with corn-starch were negative in all patients. 17 of 29 sera showed RAST (radioallergosorbent test) class 0 using latex allergen disks. SDS-PAGE (sodiumdodecylsulfate-polyacrylamide-electrophoresis) determined protein bands of less than or equal to 14 kD (not allergen specific) and approximately 28 kD. The Western Blot detected the 28 kD protein as allergen in the sera of three patients. Isoelectric focusing (IEF) proved no protein bands. Immunoprinting performed with sera of five patients presented allergen bands in an pH range between 3.8 and 4.55. This shows that radiostaining (immunoprint) is more sensitive than the Coomassie Blue staining. Although three sera showed RAST class 0, immunoblotting detected allergen bands. In these cases the immunoblot appears to be more sensitive than the RAST. A cross reactivity between latex and banana could not be established. Alternative gloves are Neolon (neoprene) or Elastyren (styrene-butadiene polymer).