Abstract
This paper describes a case of anaphylaxis due to latex exposure during surgery. Allergic reactions to latex during surgery have been described in spinal bifida patients. The case presented in our manuscript is a 15-year old girl who experienced an anaphylactic reaction during her 12th surgery of giant hairy nevus on the thigh. She had a history of oral pruritus after ingestion of chestnut suggesting latex-fruit syndrome. Specific IgE was positive to latex and the allergen components Hev b 1, 3, 5 and 6.02. The diagnosis was latex-allergy due to sensitization obtained after multiple surgeries, possibly due to the contact of latex-containing gloves. Anaphylactic shock during surgery due to NRL allergy is being reported continuously. To prevent allergic reactions during surgery in patients who undergo multiple surgeries, not only in Spina Bifida (SB) patients, frequent analyses of specific IgE to NRL are essential as well as the documentation of the clinical history after ingestion of latex-fruit syndrome related foods. Measurement of specific IgE to allergen components from NRL might be useful in the diagnosis of NRL allergy and in the investigation of the route of NRL sensitization.
Highlights
The clinical history of latex-fruit syndrome related food reactions and frequent measurement of specific IgE to natural rubber latex are important to prevent allergic reactions during multiple surgeries
natural rubber latex (NRL) allergy has been recognized as a serious health problem
High risk factors of NRL allergy are congenital abnormality in the urinary system, neural tube anomaly such as spinal bifida (SB), multiple surgeries [4], occupational exposure, allergy to foods related to latex-fruit allergy, and history of allergic diseases
Summary
The clinical history of latex-fruit syndrome related food reactions and frequent measurement of specific IgE to natural rubber latex are important to prevent allergic reactions during multiple surgeries. Sensitization to natural rubber latex (NRL) is an important cause of anaphylaxis in children requiring multiple surgeries. Those patients are repeatedly contacted with NRL from gloves and medical devices [1]. Skin prick test (SPT) and specific IgE antibody measurement to NRL are useful for diagnosing sensitization. These tests are not clinically specific due to presence of cross-reactive components in the NRL extract. Specific IgE to the other NRL components were negative (Table 1) From these results, the cause of anaphylactic shock was diagnosed as allergy to NRL due to sensitization after multiple surgeries
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