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High risk of sensitization to latex in children with spina bifida
E Beaudouin1, F Prestat, M Schmitt
1Service de Médecine D, Centre Hospitalier Universitaire de Nancy, Hôpitaux de Brabois-Hôpital d'Adultes, Nancy-Vandoeuvre, France.
Insights
Children with spina bifida have a high risk of latex hypersensitivity, increasing the danger of anaphylactic shock during surgery. Predictive tests and preventive measures are crucial for managing this risk.
Area of Science:
- Pediatric Allergy and Immunology
- Surgical Risk Assessment
Background:
- Latex allergy poses a significant risk of per-operative anaphylactic shock in children with spina bifida.
- Prior sensitization to latex is often undetected before surgical procedures.
Purpose of the Study:
- To evaluate the effectiveness of predictive tests (skin tests and RAST) for latex hypersensitivity in children with spina bifida.
- To assess the prevalence of latex hypersensitivity and identify associated risk factors in this patient group.
Main Methods:
- Study involved 30 children with spina bifida.
- Utilized skin tests and RAST (radioallergosorbent test) for hypersensitivity detection.
- Assessed patient history, atopy, and frequency of latex exposure.
Main Results:
- Latex hypersensitivity was detected in 40% (12/30) of the children.
- Atopy was significantly more prevalent (83% of hypersensitive children) compared to the general pediatric population (46%).
- Multiple latex exposures (catheterization, gloves, surgeries) contribute to sensitization.
Conclusions:
- Children with spina bifida exhibit a high rate of latent latex hypersensitivity.
- Atopy is a significant risk factor for developing latex sensitization.
- Preventive strategies, including latex-free materials and pre-operative assessments, are essential.
Abstract:
The risk of per-operative anaphylactic shock in response to latex is established in children with spina bifida. This study focuses on 30 children with spina bifida and aims at evaluating the value of predictive tests (skin tests and RAST). No patient had shown a preoperative accident. Hypersensitivity to latex, sometimes suspected by questioning of the patient, was detected 12 times out of 30 (40%). 10 children of the 12 were atopic (83%). The incidence of atopy is significantly higher than that of the general pediatric population (14 out of 30; 46%). This study demonstrates the frequency of the latent hypersensitivity to latex and the subsequent potential risk of per-operative anaphylactic shock. This sensitization can be partly explained by multiple contacts with latex; urinary catheterization several times a day, daily use of latex gloves for routine care, repetitive surgery (more than 8 operations per child). However, atopy increases the risk of sensitization to latex. The authors underline the importance of taking preventive measures for these children such as the use of PVC, silicone or polyurethane catheters and of synthetic rubber. Hypoallergenic gloves are under investigation. A questionnaire and systematic preventive cutaneous assessment before each operation are strongly advised.