Latex-food syndrome – case presentation

Abstract

Introduction. Latex allergy is a growing concern worldwide, with a prevalence of 1-20%, and a major impact on the patients quality of life of the patient, as well as a high risk of potentially life-threatening reactions. The clinical manifestations of latex hypersensitivity can be triggered by direct cutaneous contact, ingestion of cross-reacting foods, and inhalation of latex glove powder. Aim. We present a case of latex allergy in a patient with initial type I hypersensitivity reactions to latex cross-reacting foods, subsequently also showing the classical manifestations of latex hypersensitivity, and we highlight sensitization profiles in relation to their clinical impact. Method. We report the unusual course of disease in a 35-year-old female, without a family history of atopy, professionally exposed to latex for a period of seven years. the clinical manifestations of latex allergy were preceded by four years of anaphylaxis to several cross-reacting fruit and vegetables, which she merely avoided. The patient was referred to the Allergy department of the “Prof. Dr. Octavian Fodor“ Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania, when she began experiencing asthma-like attacks within minutes after arriving at the workplace. Results. Skin prick tests revealed sensitization to standardized latex extract and foods mentioned in the patient’s history. Spirometry test was within physiological limits. Serological tests showed normal tryptase levels and high specific IgE to latex (33 KU/L). Of the component allergens requested, only Hevb5 was available, with a value of 2.7 KU/L. The other components would have been useful in identifying the cross-reactivity patterns. Specific IgE panel to respiratory and food allergens were negative, but the lack of synchronization with the in vivo tests is not an unusual finding in our field and does not rules out the diagnosis. Documentation of in vivo sensitization has a positive predictive value superior to laboratory testing. The patient was educated to avoid latex and cross-reactive foods, and to self-administer epinephrine, if needed. Conclusions. Clinicians must be aware of the sources of latex allergens, as well as of the cross-reacting components found in food. Latex allergy must be suspected not only in at risk individuals (healthcare workers, spina bifida patients, atopic individuals, and those with a personal history of repeated surgeries), but also in those who react to cross-reactive foods. Diagnosing latex allergy is a challenge for both the patient and the clinician.