Latex anaphylaxis

In the past decade, immediate hypersensitivity to latex has been accepted as a serious problem. The proteins that are present in natural rubber are considered to be the responsible antigens, and the hypersensitivity responses induced include contact and generalized urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, life threatening anaphylaxis and death. So far, children with spina bifida or severe urogenital defects, health care workers, and rubber industry employees appear to be at greater risk than the general population. Since 1991 several reports and cross-reactivity studies have demonstrated an association between latex allergy and allergy to certain fruits, especially banana, avocado and kiwi. Because our knowledge of the major allergens is still incomplete, standardised in vitro and in vivo tests are not yet readily available. Therefore, the clinician should rely on a medical history, physical examination, and reliable serological tests to confirm diagnosis of latex anaphylaxis. Because of possible systemic reactions to skin prick testing and provocation tests, these methods should be restricted to patients with a compelling history and an inconclusive serologic test result. Preventive measures are the key to successful and safe management of patients with latex anaphylaxis.