Cooccurrence of latex and fruit allergies

Clinically significant allergic reactions to latex have recently been reported with increasing frequency. Most instances of latex allergy have been noted in adults who are atopic and are in the healthcare or latex manufacturing industries. Relatively few cases of latex allergy occur in pediatric patients and in these an atopic diathesis is usually also recognized. The exception are the spina bifida children who have frequent mucosal exposure to latex medical items. The cooccurrence of hypersensitivity to certain fruits in latex-allergic patients was reported by M'Rahai et al. in 1991, and this observation has since been amply confirmed in the literature. The objective was to describe a 6-year-old Caucasian boy without known atopy who presented with a history of cutaneous and respiratory reactions to banana and avocado and from whom a history of adverse reactions to common latex products was also elicited. The results of the allergy evaluation of this patient are presented. MEDLINE was searched for reports in English of latex allergy and of latex plus fruit allergy in adults and children from 1979 through 1995. In the patient presented here, immediate hypersensitivity to latex and fruit was assayed by RAST and skin tests. The RAST to latex was strongly positive, equivocal to avocado and chestnut, and negative to banana and kiwi fruit. The prick skin test was positive for banana, avocado and chestnut. Clinically significant allergy to latex and to certain fruit cooccurs. If one component of the dyad is present, the other should be sought and evaluated.