Latex allergy: clinical features and cross-reactivity with fruits

Latex IgE-mediated allergy is an important medical problem, but its clinical characteristics and association with food allergies are not well defined.

Our objectives were to determine the clinical features of latex-allergic patients, and latex-associated food hypersensitivities.

A prospective study was performed in our outpatient clinic. It consisted of a clinical questionnaire, skin prick tests with aeroallergens and foods, skin test with a latex extract, determination of total and specific IgE by CAP/RAST methods, and RAST inhibition. Latex and food allergies were diagnosed on the basis of a suggestive clinical history and a positive skin test with the corresponding allergen.

Twenty-five patients were diagnosed as having latex allergy. Their mean age was 33 +/- 9.0 years, with female predominance (23:2). There were nine greenhouse and six hospital workers. Latex-induced reactions included systemic anaphylaxis in nine patients (36%). Average total IgE was 161 kU/L, and it was within normal limits in 16 cases. Latex skin prick tests had excellent diagnostic precision with no adverse reactions, and CAP for latex diagnostic sensitivity was 80%. Forty-two food allergies were diagnosed in 13 of our patients (52%), and 23 of these consisted of systemic anaphylaxis. The most frequent food hypersensitivities were to avocado (9), chestnut (9), banana (7), kiwi (5) and papaya (3). Through RAST-inhibition, cross-reactivity among latex, avocado, chestnut, and banana was demonstrated.

In our experience, latex allergy affects middle-aged women in certain professions at increased risk. Our data suggest the existence of a "latex-fruit syndrome," because 52% of our latex allergic patients had allergies to certain fruits.