[Intraoperative anaphylactic shock due to a latex allergy]

Delayed hypersensitivity to rubber chemicals is well known, but there has been an increasing number of reports of immediate-type hypersensitivity due to latex causing contact urticaria, angioedema, bronchial asthma, and anaphylactic shock in adults. We report a 10-year-old boy who developed anaphylactic shock during surgery due to surgical gloves containing latex. The patient was atopic and had a history of neurodermatitis and localized angioedema on exposure to rubber. There had been two previous uneventful surgical procedures. Thirty-five minutes after induction of anesthesia and 5 min after laparotomy for appendectomy there was an acute onset of increased airway pressure, oxygen desaturation, and profound hypotension. The circulation and gas exchange stabilized after treatment with oxygen, intravenous fluids, epinephrine, H1 and H2 blockers, aminophylline, and methylprednisolone. A positive skin test and RAST revealed a latex allergy. Latex can cause life-threatening allergic reactions in patients with a history of rubber allergy or frequent exposure to latex products.