Comparison of latex hypersensitivity among patients with neurologic defects

Latex hypersensitivity has been described in discrete populations including health care workers and children with spina bifida (SB).

This study was designed to determine whether the SB population is a unique neuroimmunologic group manifesting this sensitivity.

Four groups of subjects were studied. These included: 36 patients with SB with or without clinical evidence of latex hypersensitivity, 50 patients with spinal cord injury (SCI), and 10 patients with cerebrovascular accidents (CVAs), all of whom were questioned regarding contact with and possible clinical allergic reactions to latex. Ten healthy control subjects were also studied. We used a latex sap extract, previously shown to react with latex-specific IgE in a biotin-avidin ELISA, to determine latex-specific IgE antibody titers and to compare the groups.

Responses to questionnaires indicated that neither the patients with SCI nor the patients with CVA had histories suggestive of latex hypersensitivity. In contrast, 72% of the SB population had histories of clinical latex allergy. Comparisons of latex contact among the SB, SCI, CVA, and control groups revealed that the SB and SCI groups had similar latex exposure, whereas the other groups had less exposure. Both the SB and SCI groups had an average of two surgical procedures per year, which was greater than the average for the other groups. Comparisons of IgE latex antibody titers among the groups indicated that only the SB group had significant levels. The mean optical density values for each group were: 0.299 +/- 0.177 for patients with SB and positive skin prick test results, 0.072 +/- 0.066 for patients with SB and negative skin prick test results, 0.098 +/- 0.005 in patients with SCI, 0.073 +/- 0.038 in patients with CVA, and 0.053 +/- 0.034 in control subjects. The percentages of positive latex IgE antibody detection were 72% for SB, 4% for SCI, 0% for CVA, and 0% for control groups.

The results suggest that the SB population is unique in demonstrating IgE responses to latex contact, which may be due to increased latex exposure or altered neuroimmunologic interactions.